The clinical performance of porcine bioprostheses for valve replacement surgery has been evaluated for over 30 years by actuarial analysis. Actual or cumulative incidence analysis provides a complementary method to determine valve-related complications due to structural valve deterioration. Here, valve-related mortality and reoperation of porcine bioprostheses for aortic and mitral valve replacement were compared by actuarial and actual methodology. Carpentier-Edwards porcine bioprostheses were implanted in 2,237 aortic valve replacements (AVR) and 1,582 mitral valve replacements (MVR). Fatal valve-related complications occurred in 7.6% of AVR and 11.3% of MVR. The cumulative follow up was 14,810 patient-years (mean 6.6 years) for AVR, and 9,718 patient-years (mean 6.1 years) for MVR. Patient survival, and actuarial and actual freedom from valve-related mortality and valve-related reoperation was reported at 15 years. The actual freedom from valve-related mortality and reoperation (primarily from structural valve deterioration), provides further evidence to consider porcine bioprostheses for AVR in patients aged >60 years, and for MVR in patients aged >70 years. Freedom from valve-related mortality supports the use of porcine bioprostheses for MVR in patients aged 61-70 years. Patient survival is influenced to the greatest extent by factors other than valve-related mortality.