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Durability of Mitral Valve Replacement With a Third-generation Bioprosthesis
Amedeo Anselmi1, Marie Aymami1, Jacques Tomasi1
1Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France.
The Annals of Thoracic Surgery
|April 26, 2021
Summary
The Epic bioprosthesis demonstrates good durability in mitral valve replacements up to 10 years. Patient age at surgery did not significantly impact structural valve deterioration (SVD) rates.
Area of Science:
- Cardiology
- Biomedical Engineering
- Surgical Innovation
Background:
- Mitral valve replacement is a critical procedure for heart failure management.
- Bioprosthetic valves offer an alternative to mechanical valves, but durability is a key concern.
- Third-generation porcine xenografts represent advancements in bioprosthetic valve technology.
Purpose of the Study:
- To evaluate the long-term durability of the Epic porcine bioprosthesis in the mitral position.
- To assess the influence of patient age at surgery on the performance of the Epic valve.
- To analyze valve-related complications and structural valve deterioration (SVD) rates.
Main Methods:
- A retrospective analysis of 482 mitral valve replacements using the Epic valve (2009-2018).
- Prospective collection of perioperative and postoperative data with systematic follow-up (99% complete).
- Stratification of patients by age at surgery to compare SVD-free survival.
Main Results:
- Overall survival at 8.8 years was 69.5%.
- Freedom from SVD at 10 years was 89.6% (actuarial).
- No significant difference in freedom from SVD or reintervention for SVD was observed across different age groups.
Conclusions:
- The Epic porcine bioprosthesis exhibits favorable durability in the mitral position over a 5-10 year follow-up period.
- Patient age at the time of mitral valve replacement does not appear to affect the long-term structural integrity of the Epic valve.
- The findings support the use of the Epic bioprosthesis in a broad range of patients undergoing mitral valve replacement.
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