The Journal of Thoracic and Cardiovascular Surgery, Vol 95, 572-576, Copyright © 1988 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Ten-year experience with pericardial xenograft valves
XD Zhu, JQ Guo, YC Chen, CJ Tang and GX Xue
Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing.
Five hundred fifty-three pericardial xenografts were inserted in 520
patients during a 9-year period at the Fu Wai Hospital in Beijing. The
bovine pericardial xenograft was modeled after a similar type of prosthesis
manufactured by Shiley Inc. (Irvine, Calif.). The late mortality rate in
this series was only 1.8% per annum and the actuarial survival rate was
73.0% +/- 12% at 10 years. There was a very acceptable low incidence of
thromboembolism of 0.41% per annum without the need for permanent
anticoagulation. This is similar to the clinical reports with other tissue
valves. The main question is the durability of the tissue prosthesis or, in
other words, the freedom from valve- related clinical complications. In
this series, the expected actuarial valve durability rate was 75.0% +/-
8.8% at 10 years. Whether this will continue to hold up over the next
follow-up period is unclear. Certainly other tissue prostheses have shown
significant degeneration rates beginning after the sixth year that have
risen progressively thereafter. In any case, given the relatively low
probability of thromboembolic phenomenon without anticoagulation, the
trade-off of a prosthesis that may not be as durable as the mechanical ones
is certainly acceptable.
