Long term follow-up of Mitroflow pericardial valve prostheses in the small aortic annulus

Between January 1985 and April 1992 we implanted 477 Mitroflow pericardial bioprostheses in 476 patients in our clinic. All except one valve prostheses were implanted in the aortic position. There were 160 male and 316 female patients, with a mean age of 74.1 years (range 30-89 years). Combined cardiac procedures were performed concomitantly with aortic valve replacement in 45 patients (9.5%): coronary artery revascularisation (n = 38), endarterectomy of the internal carotid artery (n = 4) and multiple valve replacement (n = 3). The sizes of the implanted Mitroflow prostheses were 100% in 19 mm, 70% in 21 mm, 60% in 23 mm and 8% in more than 25 mm. The hospital mortality was 1.3% (n = 5). During the mean follow-up period of 47.6 months valve failure requiring reoperation occurred in 7 patients (1.2%). The actuarial freedom from tissue failure is 89.9 +/- 2.5% and the actuarial survival rate is 90.3 +/- 1.7% (27 deaths) at 7 years. These findings corroborate our policy to continue to implant a pericardial prosthesis in the aortic position, especially in elderly patients with a smaller aortic annulus.