Abstract 19391: Early Structural Valve Deterioration of Mitroflow Aortic Bioprosthesis : Mode, Incidence and Impact on Outcome in a Large Cohort of Patients
Background: Structural valve deterioration (SVD) is a major flaw of bioprostheses. The occurrence of early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR).
Methods and Results: 617 consecutive patients underwent AVR with a Mitroflow prosthesis (model 12A or LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6% [95%CI 88.7-94.7] for the whole cohort, 79.8% [71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Overall 5-years patient survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the main correlate factor of overall mortality (HR=7.7; [95% CI;4.4-13.6]).
Conclusion: Early SVD is frequent in Mitroflow bioprosthesis (model 12A or LX), especially for small sizes (19 and 21 mm) and reduced overall survival. An unpredictable accelerated pattern of SVD constitutes a high life-threatening condition. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery may be warranted in patients with severe SVD even still asymptomatic
Author Disclosures: T. Sénage: None. J. Roussel: None. Y. Foucher: None. C. Perigaud: None. A. Mugniot: None. T. Le Tourneau: None.
- © 2014 by American Heart Association, Inc.