Midterm Outcome of Bioprosthetic Valve Replacement in North West of Iran

Although valve repair is applied usually nowadays, particularly for mitral regurgitation (MR) or tricuspid regurgitation (TR), valve replacement using prosthetic valves is common especially in adults. Unfortunately the valve with ideal hemodynamic performance and long-term durability without increasing the risk of bleeding due to long-term anticoagulant therapy does not exist. Therefore patients and physicians must choose between bioprosthetic and mechanical valve. Currently clinical trends towards the increasing use of bioprosthetic valves instead of mechanical valves even in young patients apparently because of its advantages. Seventy patients have undergone valvular replacement using bioprosthetic valves. Mean age was 54.8 years, 24 were male and 46 were female.Atrial fibrillation has been found in 34(48.6%). The patients have been evaluated by ECG and Echocardiography to assess the rhythm and ejection fracture. Mean followup time was 33 month (min 9 max 92). Mortality rate was 25.9% (n=18) within 8 years of follow-up. Statistical analysis showed a significant relation between atrial fibrillation rhythm and mortality (p=0.02). Morbidities occurred in 30 patients (42.8%). Significant statistical relation has been found between the morbidities and age over 65 years old (p=0.005). In follow-up period 4 cases (5.7%) underwent re-operation due to global dysfunctionof valve. our study shows that using bioprosthetic valve could reduce the risk of morbidity occurrence in a patient who needs valve replacement. However if medical treatments fail, in result of any reason, patients should be refered to surgical unit. This would reduce the risk of mortality because of lower incident of complications such as atrial fibrillation and morbidities due to younger patients’ population.