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Early calcification of the aortic Mitroflow pericardial bioprosthesis in the elderly

Jose Rubio Alvarez1, Juan Sierra, Marino Vega

  • 1Department of Cardiac Surgery, University Hospital of Santiago de Compostela, Spain. framan1@hotmail.com

Interactive Cardiovascular and Thoracic Surgery
|August 15, 2009
PubMed

Insights

The Mitroflow A12 bioprosthesis showed suboptimal performance in elderly patients undergoing aortic valve replacement. Freedom from structural valve dysfunction was only 55.8% at 10 years, necessitating reoperation in 4% of cases.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Biomaterials Science

Background:

  • Aortic valve replacement is a common procedure in elderly patients.
  • Pericardial bioprostheses are frequently used for aortic valve replacement.
  • The Mitroflow A12 bioprosthesis is a specific type of pericardial bioprosthesis.

Purpose of the Study:

  • To evaluate the long-term performance of the Mitroflow A12 pericardial bioprosthesis in elderly patients.
  • To assess the rates of structural valve dysfunction and bioprosthetic valve deterioration.
  • To determine the need for reoperation due to bioprosthetic valve failure.

Main Methods:

  • A retrospective study of 491 patients over 70 years old receiving the Mitroflow A12 bioprosthesis between 1993 and 2006.
  • Routine postoperative Echo-Doppler studies were performed at discharge, 1 month, and annually thereafter.
  • Follow-up included assessment of structural valve dysfunction and need for reoperation.

Main Results:

  • Twenty patients (4%) required a second aortic valve replacement due to bioprosthetic valve dysfunction, primarily calcified stenosis.
  • Freedom from structural valve dysfunction was 95.3% at 5 years and 55.8% at 10 years.
  • Freedom from bioprosthetic deterioration was 85.7% at 5 years and 33.5% at 10 years.

Conclusions:

  • The Mitroflow A12 pericardial bioprosthesis demonstrates suboptimal long-term performance in elderly patients.
  • High rates of structural valve dysfunction and deterioration necessitate reoperation.
  • Alternative bioprosthetic options may be considered for this patient population.
Abstract

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