Long-term outcomes of surgical aortic valve replacement using a third-generation stented bovine pericardial bioprosthesis in 1907 patients.

OBJECTIVES: This large, single-center evaluation presents long-term survival, reintervention, and echocardiographic outcomes after implantation of a third-generation supra-annular stented bovine pericardial aortic valve with a proprietary anticalcification treatment. METHODS: After excluding patients with ventricular assist devices, congenital repairs, and heart transplants, 1907 patients underwent aortic valve replacement with this bioprosthetic valve between August 2010 and September 2023. Primary outcomes were freedom from all-cause mortality and reintervention for structural valve deterioration. Secondary outcomes included mean transprosthetic gradient and Valve Academic Research Consortium 3-defined severe hemodynamic valve dysfunction. RESULTS: Among 1907 patients included, 30-day mortality was 2.8% (N = 54), stroke occurred in 2.8% (N = 53), and a permanent pacemaker was implanted in 3.3% (N = 62). Echocardiographic follow-up was available in 90.46% of patients (mean follow-up: 4 years; total 6557 echocardiograms reviewed). Overall mean transprosthetic gradient was 11.76 ± 6.52 mm Hg, 12.87 ± 7.52 mm Hg, 16.10 ± 11.02 mm Hg, and 16.01 ± 8.31 mm Hg at 1, 5, 10, and 12 years, respectively. Overall survival was 93.25%, 77.62%, 47.99% and 37.84% at 1, 5, 10, and 12 years, respectively. Freedom from stage 3 hemodynamic valve dysfunction was 99.08%, 85.75%, and 64.32% at 5, 10, and 12 years, respectively. Structural valve deterioration-related reintervention occurred in 2.7% of patients (N = 51), with freedom from reintervention at 98.32%, 90.80%, and 85.13% at 5, 10, and 12 years, respectively. CONCLUSIONS: Long-term outcomes of this bioprosthetic valve are characterized by excellent overall survival, low structural valve deterioration rates, and sustained hemodynamic performance through 12 years of follow-up.