Portal de Periódicos da CAPES

Early structural valve deterioration and reoperation associated with the mitroflow aortic valve

2018; Wiley; Volume: 33; Issue: 12 Linguagem: Inglês

10.1111/jocs.13953

1540-8191

Andrea L. Axtell, David C. Chang, Serguei Melnitchouk, Arminder S. Jassar, George Tolis, Mauricio A. Villavicencio, Thoralf M. Sundt, David A. D’Alessandro,

Aortic Disease and Treatment Approaches

Journal of Cardiac SurgeryVolume 33, Issue 12 p. 778-786 ORIGINAL ARTICLE Early structural valve deterioration and reoperation associated with the mitroflow aortic valve Andrea L. Axtell MD, Andrea L. Axtell MD orcid.org/0000-0003-0916-3327 Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts Minehan Outcomes Fellow, Minehan Heart Center, Boston, MassachusettsSearch for more papers by this authorDavid C. Chang PhD, MPH, MBA, David C. Chang PhD, MPH, MBA Codman Center for Clinical Effectiveness, Department of Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorSerguei Melnitchouk MD, MPH, Serguei Melnitchouk MD, MPH Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorArminder S. Jassar MD, Arminder S. Jassar MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorGeorge Tolis MD, George Tolis MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorMauricio A. Villavicencio MD, MBA, Mauricio A. Villavicencio MD, MBA Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorThoralf M. Sundt MD, Thoralf M. Sundt MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorDavid A. D'Alessandro MD, Corresponding Author David A. D'Alessandro MD dadalessandro@mgh.harvard.edu Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts Correspondence David D'Alessandro MD, Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, 55 Fruit Street, Cox 630, Boston, MA 02114. Email: dadalessandro@mgh.harvard.eduSearch for more papers by this author Andrea L. Axtell MD, Andrea L. Axtell MD orcid.org/0000-0003-0916-3327 Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts Minehan Outcomes Fellow, Minehan Heart Center, Boston, MassachusettsSearch for more papers by this authorDavid C. Chang PhD, MPH, MBA, David C. Chang PhD, MPH, MBA Codman Center for Clinical Effectiveness, Department of Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorSerguei Melnitchouk MD, MPH, Serguei Melnitchouk MD, MPH Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorArminder S. Jassar MD, Arminder S. Jassar MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorGeorge Tolis MD, George Tolis MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorMauricio A. Villavicencio MD, MBA, Mauricio A. Villavicencio MD, MBA Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorThoralf M. Sundt MD, Thoralf M. Sundt MD Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, MassachusettsSearch for more papers by this authorDavid A. D'Alessandro MD, Corresponding Author David A. D'Alessandro MD dadalessandro@mgh.harvard.edu Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Massachusetts Correspondence David D'Alessandro MD, Corrigan Minehan Heart Center and Division of Cardiac Surgery, Massachusetts General Hospital, 55 Fruit Street, Cox 630, Boston, MA 02114. Email: dadalessandro@mgh.harvard.eduSearch for more papers by this author First published: 07 December 2018 https://doi.org/10.1111/jocs.13953Citations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract 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. Citing Literature Volume33, Issue12December 2018Pages 778-786 RelatedInformation