Clinical and hemodynamic performance of the 19-mm medtronic mosaic bioprosthesis.

Détails

ID Serval
serval:BIB_180CEE31A022
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Clinical and hemodynamic performance of the 19-mm medtronic mosaic bioprosthesis.
Périodique
The Journal of heart valve disease
Auteur⸱e⸱s
Kirsch M.E., Tzvetkov B., Vermes E., Pouzet B., Sauvat S., Loisance D.
ISSN
0966-8519 (Print)
ISSN-L
0966-8519
Statut éditorial
Publié
Date de publication
05/2005
Peer-reviewed
Oui
Volume
14
Numéro
3
Pages
433-439
Langue
anglais
Notes
Publication types: Clinical Trial ; Journal Article
Publication Status: ppublish
Résumé
The Medtronic Mosaic valve (MMV) is a latest generation supra-annular stented porcine valve, which combines a low-profile stent, leaflet fixation at zero pressure in a predilated aortic root, and amino-oleic acid anti-mineralization treatment for improved hemodynamics and durability. A study was conducted to evaluate the clinical and hemodynamic performances of the MMV in patients with a small aortic root (19 mm aortic annulus).
Between 1998 and 2004, 81 consecutive patients (69 females, 12 males; mean age 78.0 +/- 5.5 years) underwent aortic valve replacement using the 19-mm MMV. Concomitant coronary artery bypass grafting was performed in 28 patients (29.2%), and mitral valve surgery in one patient (1.2%).
The 30-day mortality rate was 9.9% (eight deaths). Postoperative actuarial survival estimates were 90.1 +/- 3.3%, 78.5 +/- 4.6% and 69.1 +/- 5.5% at one month, one year and two years, respectively. After a mean follow up of 2.7 +/- 1.9 years, no cases of structural dysfunction, non-structural dysfunction or valve thrombosis were noted. Four ischemic cerebral complications (2.0% per patient-year (pt-yr)), five bleeding complications (2.0%/pt-yr) and two prosthetic valve infections (1.0%/pt-yr) were observed. No reoperation on a MMV was performed. Postoperatively, the mean systolic gradient was 23.4 +/- 7.0 mmHg, and the effective orifice area (EOA) 1.06 +/- 0.33 cm2. Valve prosthesis-patient mismatch (VP-PM) was moderate (indexed EOA > 0.65 cm2/m2 and < or = 0.85 cm2/m2) in 40 patients (49.4%), and severe (indexed EOA < or = 0.65 cm2/m2) in 41 (50.6%).
Although providing acceptable clinical results, implantation of the 19-mm MMV resulted in a high incidence of postoperative VP-PM. Hence, this valve should be reserved for patients in whom the projected indexed EOA calculated preoperatively is deemed acceptable, given the patient's clinical condition.
Mots-clé
Aged, Aged, 80 and over, Aortic Valve, Aortic Valve Insufficiency/surgery, Aortic Valve Stenosis/surgery, Bioprosthesis, Brain Ischemia/etiology, Endocarditis, Bacterial/etiology, Female, Follow-Up Studies, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Patient Selection, Postoperative Complications, Postoperative Hemorrhage/etiology, Prosthesis Design, Prosthesis-Related Infections/etiology, Survival Rate, Ventricular Pressure/physiology
Pubmed
Web of science
Création de la notice
30/03/2019 16:51
Dernière modification de la notice
20/08/2019 12:48
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