Abstract:
:We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P <0.0001). Thromboembolic episodes occurred in 4 patients, with an actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm(2); in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm(2). During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement.
journal_name
Tex Heart Inst Jjournal_title
Texas Heart Institute journalauthors
Celiento M,Blasi S,De Martino A,Pratali S,Milano AD,Bortolotti Udoi
10.14503/THIJ-14-4407subject
Has Abstractpub_date
2016-02-01 00:00:00pages
13-9issue
1eissn
0730-2347issn
1526-6702journal_volume
43pub_type
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
pub_type: 杂志文章
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journal_title:Texas Heart Institute journal
pub_type: 杂志文章
doi:
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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journal_title:Texas Heart Institute journal
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