Background: In the current surgical era, the use of bioprosthetic valves may be limited because of their suboptimal hemodynamic performance and limited durability. Thrombo-embolic events and anticoagulation-related bleeding associated with the use of mechanical valves may lead to irreversible complications. Recently, the use of the bioprosthetic valves has been increased especially in elderly patients having co-morbid risk factors.

Methods: Between February 2005-April 2006, 47 bioprosthetic valves were implanted in 44 patients (30 males, 14 females; mean age 71±6.5). The age limits for aortic and mitral bioprosthetic valve replacement were 55 and 60 years, respectively. All operations were performed electively under standard cardiopulmonary bypass at moderate hypothermia (28 ºC). Thirty bioprosthetic valves were used in the mitral position while 17 bioprosthetic valves were used in the aortic position. Three patients underwent a double-valve replacement and nine patients underwent concomitant coronary artery bypass grafting procedure. Pulmonary vein isolation was performed in 12 patients.

Results: Overall mortality was 2.27% (n=1). The patient who underwent double-valve replacement and four vessel coronary artery bypass grafting died on the postoperative day 12 because of heparin-induced trombocytopenia following hemodialysis. Prolonged mechanical ventilation was observed in three patients and all these patients were extubated within 72 hours. The hemodynamic performance of the valves were evaluated by echocardiography before discharge. Mean transvalvular gradient was 5.5±1.5 mmHg at mitral position and peak transvalvular gradient was 23±9 mmHg at aortic position.

Conclusion: As a result, second generation pericardial valves have an acceptable hemodynamic performance in the early postoperative period and should be considered as safe substitutes in elderly patients having multiple preoperative co-morbid factors.

Keywords : Bioprosthesis; heart valve prosthesis; hemodynamic processes