LONG-TERM RESULTS OF MITRAL VALVE REPLACEMENT WITH PROSTHESIS "BioLAB"
Objective - to analyze the results of implantation of xenopericardial bioprosthesis “BioLAB” in the mitral position at follow-up of 15 years. Material and methods. From January 1993 to December 2008 were implanted 83 bioprosthesis of “BioLAB” in mitral valve position in 81 patients. The average age was 64.2±6.1 years (51-73 years). The main reason for the formation of heart disease was rheumatism in 63 (78%) patients. All patients were in NYHA class III and IV, 52 (64%) patients had permanent atrial fibrillation. Results. 30-day mortality was 8,7% ( n = 7). At the hospital stage were two redo's, because of prosthetic dysfunction in the form of sagging flaps, and in cause of early prosthetic endocarditis development. The remaining patients were discharged in satisfactory condition. In the long-term period the fate of 67 patients was known, 6 patients were lost from observation for different reasons. 33 patients died for various reasons. Survival in up to 5, 10 and 15 years after surgery was 72.3 ± 5.6, 55.2 ± 6.6, 22.8 ± 12.1% respectively. Freedom from degeneration of bioprosthesis among survived patients was 73.3 ± 6.4% at 8 years, 65.2 ± 7.2% at 10 years and 50.2 ± 9.6% at 12 years. In the long-term period 14 redo's were performed due to dysfunction of bioprosthesis. The average time before the second operation was 7.5 years (from 4 to 10 years). 4 (28%) patients died after reoperation during hospital stay. Conclusions. Considering the life expectancy in the general population and the survival rate up to 15 years in our study it is possible to implant xenopericardial prosthesis of «BioLAB» in mitral valve position, in patients older than 75 years or earlier, if there is presence of absolute contraindications for receiving indirect anticoagulants. Improved methods of processing and creation of new biological tissues may allow us to recommend biological prostheses for the mitral position for younger patients in future.