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Early structural valve deterioration and reoperation associated with the mitroflow aortic valve
Author(s) -
Axtell Andrea L.,
Chang David C.,
Melnitchouk Serguei,
Jassar Arminder S.,
Tolis George,
Villavicencio Mauricio A.,
Sundt Thoralf M.,
D'Alessandro David A.
Publication year - 2018
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.13953
Subject(s) - medicine , aortic valve , cardiology
Background Structural valve deterioration (SVD) is a known limitation of bioprosthetic valves. Recent reports have suggested a concerning rate of early SVD in patients receiving a Mitroflow aortic bioprosthesis. We therefore compared the incidence of SVD and SVD requiring reoperation among patients receiving a Mitroflow versus a common contemporary bioprosthesis. Methods A retrospective cohort analysis was performed on 592 patients receiving a Mitroflow aortic bioprosthesis at our institution between 2010 and 2014. Patients were matched 1:1 using a coarsened exact matching algorithm with patients receiving a Carpentier‐Edwards Magna Ease aortic bioprosthesis (Edwards Lifesciences, Irvine, CA) during the same period. The incidence of SVD (defined as a mean transprosthetic gradient ≥30 mmHg or moderate to severe intraprosthetic regurgitation), reoperation for SVD, and cumulative survival were compared between prosthesis types. Results The cumulative incidence of SVD at 5 years for all patients receiving a Mitroflow aortic bioprosthesis was 16% (13‐21%) and 5% underwent reoperation for SVD. Implantation of a Mitroflow valve was associated with an increased risk of SVD compared to the comparator valve (hazard ratio [HR] 2.59 [1.69‐3.98], P < 0.01). Older age had a protective effect against SVD (HR 0.95 [0.93‐0.96], P < 0.01). Patients who received a Mitroflow valve had reduced long‐term survival compared to those who received a comparator valve ( P = 0.03). Conclusion The Mitroflow aortic bioprosthesis is associated with increased rates of early SVD and reoperation for valvular dysfunction as well as reduced survival compared to a contemporary valve. Enhanced clinical and echocardiographic follow‐up is advisable after Mitroflow implantation.