[Findings of the Carpentier-Edwards porcine bioprosthesis in the mitral position with PTF in the 16th post-operative year].

A 62-year-old woman, who had ever undergone mitral valve replacement with a 29 mm Carpentier-Edwards (C-E) porcine bioprosthesis for mitral regurgitation, was admitted to our hospital because of progressive dyspnea on effort. Transthoracic and transesophageal echocardiography revealed primary tissue failure (PTF) of the C-E bioprosthesis with prolapsing, thickening and impaired mobility of the leaflets which resulted in severe mitral stenosis and regurgitation. The patient was scheduled to elective operation for redo mitral valve replacement with a prosthetic mechanical valve. The removed C-E bioprosthesis showed (1) leaflet perforation, (2) commissural tear, (3) pannus overgrowth, (4) impaired leaflet mobility and (5) diffuse calcification. Despite all attempt to improve on bioprosthetic features, reported free rate from PTF decreased approximately after 10th postoperative year in any types of bioprostheses available. Our various degenerative findings on the C-E bioprosthesis in the 16th postoperative year may suggest the limitation of long-term durability of the bioprostheses, which needs to be concerned about in their surgical indication and choice.