Pietro Giorgio Malvindi1, Florinda Mastro2, Mariusz Kowalewski3, Margot Ringold2, Vito Margari1, Piotr Suwalski4, Giuseppe Speziale5, Domenico Paparella6. 1. Cardiothoracic Department, Santa Maria Hospital, GVM Care & Research, Bari, Italy. 2. Department of Emergency and Organ Transplant, University of Bari Aldo Moro, Bari, Italy. 3. Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland; Cardiothoracic Research Centre, Innovative Medical Forum, Bydgoszcz, Poland; Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, The Netherlands. 4. Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior, Centre of Postgraduate Medical Education, Warsaw, Poland. 5. Cardiothoracic and Vascular Department, Maria Cecilia Hospital, GVM Care & Research, Cotignola (RA), Italy. 6. Cardiothoracic Department, Santa Maria Hospital, GVM Care & Research, Bari, Italy; Department of Emergency and Organ Transplant, University of Bari Aldo Moro, Bari, Italy. Electronic address: domenico.paparella@uniba.it.
Abstract
BACKGROUND: Porcine and pericardial valves exhibited similar freedom from structural valve deterioration after aortic valve replacement. Limited data exist regarding their durability at long-term follow-up in the mitral position. METHODS: A literature search was performed through online databases. Papers reporting freedom from tissue valve deterioration after mitral valve replacement with a follow-up longer than 5 years were retrieved. Four porcine valves (Carpentier-Edwards [Edwards Lifesciences, Irvine, CA] and Hancock, Hancock II, and Mosaic [Medtronic, Inc, Minneapolis, MN]) and 1 pericardial prosthesis (Carpentier-Edwards) were the objects of the study. The structural valve deterioration (SVD) rate per year was calculated for each type of prosthesis. Kaplan-Meier curves and log-rank test analysis were performed to compare the long-term durability of porcine and pericardial valves. RESULTS: Forty full-text papers including more than 15,000 patients were considered for the meta-analysis. Porcine valves were generally implanted in younger patients in the first period after their introduction. The mean age of the patients receiving a mitral bioprosthesis increased from 50 to 70 years over the decades. In patients operated after 1980 who had similar mean age at the time of implant, freedom from SVD was higher in the group of porcine valves with Mosaic prosthesis, showing the lowest rate of SVD. Long-term survival was higher for Mosaic porcine and Carpentier pericardial valves. CONCLUSIONS: In surgical populations that underwent mitral valve replacement after 1980 with new generation tissue valves and similar mean age at the implant time, we found, at long-term follow-up, a higher freedom from SVD in the group of porcine prostheses.
BACKGROUND: Porcine and pericardial valves exhibited similar freedom from structural valve deterioration after aortic valve replacement. Limited data exist regarding their durability at long-term follow-up in the mitral position. METHODS: A literature search was performed through online databases. Papers reporting freedom from tissue valve deterioration after mitral valve replacement with a follow-up longer than 5 years were retrieved. Four porcine valves (Carpentier-Edwards [Edwards Lifesciences, Irvine, CA] and Hancock, Hancock II, and Mosaic [Medtronic, Inc, Minneapolis, MN]) and 1 pericardial prosthesis (Carpentier-Edwards) were the objects of the study. The structural valve deterioration (SVD) rate per year was calculated for each type of prosthesis. Kaplan-Meier curves and log-rank test analysis were performed to compare the long-term durability of porcine and pericardial valves. RESULTS: Forty full-text papers including more than 15,000 patients were considered for the meta-analysis. Porcine valves were generally implanted in younger patients in the first period after their introduction. The mean age of the patients receiving a mitral bioprosthesis increased from 50 to 70 years over the decades. In patients operated after 1980 who had similar mean age at the time of implant, freedom from SVD was higher in the group of porcine valves with Mosaic prosthesis, showing the lowest rate of SVD. Long-term survival was higher for Mosaic porcine and Carpentier pericardial valves. CONCLUSIONS: In surgical populations that underwent mitral valve replacement after 1980 with new generation tissue valves and similar mean age at the implant time, we found, at long-term follow-up, a higher freedom from SVD in the group of porcine prostheses.
Authors: Matteo Marro; Alexander P Kossar; Yingfei Xue; Antonio Frasca; Robert J Levy; Giovanni Ferrari Journal: J Am Heart Assoc Date: 2021-01-26 Impact factor: 5.501