Long-term results after aortic valve replacement with the biocor PSB stentless xenograft in the elderly

Background. This study seeks to define the long-term results after Biocor PSB stentless aortic valve replacement (AVR) in elderly patients, including the effects of No-React treatment. Methods. We reviewed the outcomes of 106 consecutive patients, aged 70 +/- 6 years, having Biocor PSB (93 standard, 13 No-React) AVR between October 1992 and October 1996. Results. There were three early deaths (3%) and 15 late deaths (15%), during a mean follow-up of 5.8 +/- 1.6 years. At 8 years, survival was 82% +/- 4% and freedom from cardiac death was 94% +/- 3%. Freedom from valve failure was 92% +/- 4% at 8 years (No-React: 92% +/- 8% at 4 years). Replacement of the xenograft was required in 5 patients. Freedom from reoperation was 91% +/- 4% at 8 years (No-React: 92% +/- 8% at 4 years). Four bleeding and two embolic events were recorded: overall valve-related event-free survival was 81% +/- 7% at 8 years (No-React: 76% +/- 12% at 4 years). Age of long-term survivors averaged 77 +/- 5 years and their New York Heart Association status was 1.3 +/- 0.6 (versus 2.9 +/- 0.6 preoperatively, p = 0.01). Conclusions. Satisfactory freedom from cardiac events and from valve deterioration added to uniform improvement in functional status despite advanced age and high prevalence of comorbid conditions make AVR with the Biocor PSB xenograft a valid long-term therapy for the elderly. No-React treatment does not influence xenograft durability. (C) 2001 by The Society of Thoracic Surgeons.