Durability after aortic valve replacement with the Mitroflow versus the Perimount pericardial bioprosthesis: a single-centre experience in 2393 patients
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVES: This study compares the durability and risk of reoperation in patients undergoing aortic valve replacement (AVR) with either a Mitroflow or a Carpentier-Edwards (CE) pericardial bioprosthesis. Since AVR with bioprosthetic valves has increased progressively in recent years as compared to mechanical valves, especially in patients aged 60-70 years, there has been renewed interest in the long-term durability of current pericardial bioprostheses.
METHODS: We compared 440 AVR with Mitroflow valves with 1953 AVR with CE pericardial valves implanted from 1999 to 2014 with regard to reoperation, reoperation for structural valve deterioration (SVD) and all-cause mortality.
RESULTS: Ten-year freedom from explant of any cause was higher for CE Perimount (98 ± 0.7%) than for Mitroflow (95 ± 1.4%, P < 0.01). Reasons for explant for CE Perimount were SVD (n = 2), endocarditis (n = 8) and paraprosthetic leak (n = 10). The reasons for explant for Mitroflow were SVD (n = 11), endocarditis (n = 3) SVD and pericarditis (n = 1) and paraprosthetic leak (n = 2). Ten-year freedom from explant due to SVD was higher for CE Perimount (100%) than for Mitroflow (96%) (P < 0.01). In small aortic annuli (bioprosthesis size 19-21 mm), freedom from SVD at 10 years for CE Perimount and Mitroflow was 100 versus 96%, respectively. By multivariate analysis, it was found that bioprosthesis size was not a risk factor for SVD. The choice of valve type could not be demonstrated to influence long-term survival.
CONCLUSIONS: The Mitroflow pericardial bioprosthesis provides less than optimal mid- and long-term durability compared with the CE Perimount pericardial valve, especially for small aortic diameter implants (19 and 21 mm). This study hereby confirms the existence of a real risk of valvular deterioration of the Mitroflow valve that might compromise the prognosis of the patients.
Original language | English |
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Journal | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery |
Volume | 49 |
Issue number | 6 |
Pages (from-to) | 1705-10 |
Number of pages | 6 |
ISSN | 1010-7940 |
DOIs | |
Publication status | Published - Jun 2016 |
- Aged, Aortic Valve/surgery, Bioprosthesis, Endocarditis/surgery, Female, Heart Valve Diseases/surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/adverse effects, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Pericardium/transplantation, Prosthesis Design, Prosthesis Failure, Prosthesis-Related Infections/surgery, Reoperation/methods
Research areas
ID: 246355556