Long-Term Results with the Xenomedica® Porcine Bioprosthesis in the Mitral Position
Francesco Santini MD, Stefano Auriemma MD, Gianluca Casali MD, Andrea Rossi MD, Mario Lusini MD, Alessandro Mazzucco MD

The long-term fate of the Xenomedica heart valve prosthesis, a low-pressure, glutaraldehyde-preserved porcine aortic valve, with low-profile mounting, when implanted in the mitral position in 242 patients was evaluated retrospectively. Preoperatively, 92% of patients were in NYHA classes III or IV, 83% were in atrial fibrillation, and 39% had undergone previous cardiac surgery. Early mortality was 8.2%, and late mortality 45% (cardiac deaths 37%; valve related 17%). Actuarial survival at 5, 10 and 15 years was 69 ± 3%, 52 ± 3% and 38 ± 4%. Structural valve deterioration occurred in 33% of survivors, developed in a progressive fashion, and was the leading cause for reoperation (actuarial estimates of freedom at 5, 10 and 15 years of 93 ± 2%, 64 ± 4% and 25 ± 9%). The Xenomedica heart valve prosthesis, when implanted in the mitral position, showed results in line with those for other first-generation bioprostheses, though the incidence of primary tissue failure within 10 years was unsatisfactory.