Ten year experience with Aspire (Tissuemed) porcine bioprosthesis: single centre experience

Abstract

Background: Aspire (Tissuemed) bioprosthesis is a third generation porcine bioprosthesis. 10-year outcome of this bioprosthesis is unknown. Methods: We report our experience of 139 consecutive prosthesis implanted between 1990–1998. The clinical outcome was reviewed retrospectively. Results: 126 patients (67 males and 59 females), mean age 68.4±8.4 years underwent 139 valve replacements. Sites of valve implantation included the aortic in 77 patients (61%); mitral in 35 patients (27%); aortic+mitral in 13 patients (10%) and tricuspid in 1 patient (0.8%). 32/126 patients (25%) also underwent concomitant coronary artery bypass grafting (CABG). 30-day mortality for the whole group was 8.7% (11/126) with no valve related deaths. Follow up was 98.4% complete with a mean follow up of 6.1±3.3 years (766 patient-years, range 0–10.2 years). Overall 10-year actuarial survival was 41±7% (AVR 49±10%, MVR 29±11%) and this was influenced by pre-operative poor left ventricular function (EF<30%) ( p=0.007) and pre-operative NYHA class III/IV ( p=0.001). Overall estimated 10-year actuarial freedom from valve related events (Kaplan–Meier) and valve related events expressed as linearised rates (%/patient–year) were: freedom from structural valve failure 97±2% (0.26%/patient–year); non-structural dysfunction 98±1% (0.13%/patient-year); freedom from prosthetic valve endocarditis 94±3% (0.39%/patient–year); freedom from significant haemorrhagic event 82±6% (1.33%/patient–year); freedom from thrombo-embolism 90±3% (0.91%/patient–year) and freedom from re-operation was 93±3% (0.52%/patient–year). Conclusion: In our experience Aspire (Tissuemed) porcine bioprosthesis functions satisfactorily at 10-years with low valve related complications. Further follow-up will determine its long-term durability.