Contemporary evidence of long-term follow-up of the Epic^TM prosthesis after mitral valve replacement

To verify the long-term durability, freedom from reoperation and mortality of Biocor and Epic bioprosthesis in mitral position.

The use of biological prostheses in mitral valve replacement surgery is widespread. Advances in transcatheter techniques have increased the utilisation of these biological substitutes, rendering the study of their durability once again pertinent. Biocor and Epic are two stented tissue valves with porcine leaflets indicated for patients requiring replacement of a diseased mitral or aortic heart valve. Long-term follow-up data were collected and analysed by age group and by type of surgery. Between 2000 and 2010, 244 patients underwent mitral or double valve replacement with a Biocor or Epic bioprosthesis at our institution. The median follow-up was 9 years (IQR: 0.01- 17.9). Complete follow-up was achieved in 98.4%.

The survival rates at 1, 5 and 10-years were 90, 73.7 and 43 %, respectively. Freedom from prothesis reintervention from any cause at 1, 5 and 10 years was 98.5, 92.8 and 90%. Freedom from structural valve deterioration by age group at 1, 5 and 10 years was as follows: age<60: 100, 84.6 and 47.6; age 60-69: 100, 94.1 and 94.1; and age≥70: 99.4, 98.7 and 96.5% respectively.

Our 10-year freedom from structural valve deterioration of 93.1% matches, and may even surpass those previously reported. The Epic porcine xenograft in mitral position has demonstrated to have excellent durability and long-term outcomes; representing an excellent option for patients in need for mitral valve replacement.