Prevention of bioprosthetic porcine and pericardial valve failure and improved patient survival using HMG-CoA reductase inhibitors

K. W. Gregory, Y. Wu, A. Starr, G. Grunkemeier

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Background: Bioprosthetic heart valve failure results in substantial morbidity and mortality. Bioprosthetic heart valve (BPV) and other bioprosthetic devices have dysfunction and failure modes that are many times due to lipid adsorption and calcific degeneration. Lipid adsorption and calcific degeneration is also a common cause of coronary artery and saphenous vein graft dysfunction and failure that could be prevented or reduced with lipid lowering drugs. We hypothesized that treatment of bioprosthetic heart valves with HMG CoA reductase inhibitors, which have been used successfully to reduce morbidity and mortality of atherosclerotic lesions may reduce BPV failure and need for replacement. Methods: During 1976-1996, 439(342) porcine valves and during 1991-2002, 1021(673) pericardial valves were used for isolated aortic valve replacement by our surgical group. Thirty-seven porcine and 286 pericardial valve patients have reported any use of statins. Patient survival and SVD were analyzed retrospectively. Results: The age distribution of the groups are very similar for both porcine and pericardial valves. The mean and maximum follow-up years were 6.5 and 18 years for porcine, 2.5 and 10 years for pericardial. For porcine, 15 years survival were 41 ±12% for patients in the lipid lowering group and 10±2% for patients with no use of these drugs (p<0.001). For pericardial, 10 years survival were 72±6% for and 30±7% for (p<0.001) respectively. In patients receiving lipid-lowering drugs no SVD was observed in porcine and 2 in pericardial (p<0.03). Conclusion: In this retrospective study, the use of lipid lowering drugs is associated with a remarkable reduction of bioprosthetic valve dysfunction requiring valve replacement as well as a highly significant improvement of patient survival. Prevention of lipid and inflammatory reduction of bioprosthetic implants with lipid lowering drugs may be the explanation for this effect and may point to an important improvement in bioprosthetic valve durability and function. Similar prevention of other bioprosthetic calcification and failure may also be possible.

Original languageEnglish (US)
Title of host publicationTransactions - 7th World Biomaterials Congress
Number of pages1
StatePublished - Dec 1 2004
EventTransactions - 7th World Biomaterials Congress - Sydney, Australia
Duration: May 17 2004May 21 2004

Publication series

NameTransactions - 7th World Biomaterials Congress

Other

OtherTransactions - 7th World Biomaterials Congress
CountryAustralia
CitySydney
Period5/17/045/21/04

ASJC Scopus subject areas

  • Engineering(all)

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    Gregory, K. W., Wu, Y., Starr, A., & Grunkemeier, G. (2004). Prevention of bioprosthetic porcine and pericardial valve failure and improved patient survival using HMG-CoA reductase inhibitors. In Transactions - 7th World Biomaterials Congress (Transactions - 7th World Biomaterials Congress).