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Durability of Mitral Valve Replacement With a Third-generation Bioprosthesis
- Source :
- The Annals of Thoracic Surgery. 113:837-844
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Background Our aim was to evaluate the durability of a third-generation porcine bioprosthesis (Epic porcine xenograft; Abbott Cardiovascular Inc, St Paul, MN) in the mitral position, according to patients’ age at surgery. Methods Four hundred eighty-two mitral valve replacements using the Epic valve at a single center were included (2009-2018). Perioperative and early postoperative data were prospectively collected. A systematic follow-up was performed (99% complete, 1609.5 patient-years; average, 3.8 ± 2.5). Standardized definitions of valve-related events were adopted. Mean patient age at mitral valve replacement was 68.1 ± 10.4 years. Results Operative mortality was 9.3%. There were 5 early valve-related reoperations, mainly due to recurrent infectious endocarditis. Global survival at 8.8 years was 69.5% ± 5%. Nine structural valve deterioration (SVD) events occurred during follow-up (3 receiving reoperations, 4 transcatheter mitral valve replacement valve-in-valve, and 2 medical treatment only). The freedom from SVD at 5 and 10 years was 97.4% ± 1.2% and 89.6% ± 4.4% (actuarial) and 97.8% ± 1% and 91.9% ± 3.3%, respectively (competing risks). After stratification into subgroups by age at surgery (≤59 years, 50.8%; 60-69, 32.8%; ≥70, 16.4%) there was no significant intergroup difference in freedom from SVD (log-rank P = .24). The overall freedom from any reintervention for SVD at 10 years was 90.5% ± 4.4% (actuarial) and 92.7% ± 3.3% (competing risks), with no intergroup difference (log-rank P = .14). The freedom from any valve-related complication at 8.4 years was 83.2% ± 4.5% (actuarial). Conclusions The Epic bioprosthesis shows good durability at 5 to 10 years in the mitral position.
- Subjects :
- Reoperation
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Swine
medicine.medical_treatment
Single Center
Postoperative Complications
Mitral valve
medicine
Animals
Humans
Endocarditis
Bioprosthesis
Heart Valve Prosthesis Implantation
Medical treatment
business.industry
Mitral valve replacement
Perioperative
medicine.disease
Third generation
Prosthesis Failure
Surgery
medicine.anatomical_structure
Aortic Valve
Heart Valve Prosthesis
Mitral Valve
Cardiology and Cardiovascular Medicine
Complication
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00034975
- Volume :
- 113
- Database :
- OpenAIRE
- Journal :
- The Annals of Thoracic Surgery
- Accession number :
- edsair.doi.dedup.....9f54cfc90cf0c2e23fb0fff1aa4fdeb3