Pathologic findings after cardiac valve replacement with glutaraldehyde-fixed porcine valves.

Although approximately 20,000 glutaraldehyde-fixed porcine cardiac valve prostheses have been implanted in patients there is a lack of detailed pathologic studies of valves removed surgically or examined at necropsy. In this study, of 363 valves implanted in 311 patients, 26 valves (7 percent) from 23 patients (7 percent) were examined morphologically. Of the 23 patients, 14 died intraoperatively or less than 1 month after valve replacement—3 from coronary artery disease, 4 from hemorrhagic myocardial necrosis, 2 from postoperative hemorrhage, 2 from pulmonary disease and 1 from phycomycosis of the prosthesis; in 2 patients no anatomic cause of death was found. Six patients died 1 to 9 months after valve replacement—one from prosthetic thrombotic stenosis, one from prosthetic endocarditis and four from causes unrelated to their prosthesis. Three patients underwent surgical excision of a malfunctioning valve 12 to 31 months after implantation; incompetence was due to infective endocarditis in two patients and to a torn cusp in one.