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Long-term Outcomes Of Small-size Heart Valve Bioprostheses: Comparative Study Between Mitroflow And Magna Pericardial Xenografts
ZAID ALHAMWY, A. Baluja, S. Souaf, B. Adrio, J. Sierra, D. Duran, J. Garcia, AL. Fernandez Gonzalez.
University of Santiago de Compostela, Santiago de Compostela, Spain.

OBJECTIVE: •The small-size Mitroflow prosthetic xenograft has been widely used in high risk older patients because its satisfactory hemodynamic characteristics and easy implantation technique•However early structural valve deterioration has been described after Mitroflow valve implantation•There is a limited number of studies comparing the performance of the Mitroflow prosthesis with other different small-size aortic bioprosthesis in the same population•The objective of this retrospective study is to evaluate the clinical profile, long term survival and reoperation in a group of older patients who received small size aortic bioprosthesis.

PATIENTS:

  • From January 2008 until December 2012
  • 166 consecutive 19-mm and 21-mm Mitroflow aortic valves
  • 93 consecutive 19-mm and 21-mm Magna aortic valves

    METHODS:
  • Same surgical team
  • Patients randomly assigned to a surgeon
  • Free of choice of the prosthesis according to surgeon´s preference
  • Same surgical technique: supranaular placement with 2-0 pledgeted interrupted sutures
  • Postoperative echocardiography and clinical follow-up at regular intervals
  • Patient Prostheses Mismatch defined as:
  • Moderate: effective orifice index area 0.65-0.85 cm2/m2
  • Severe: EOIA < 0.65 cm2/m2

    RESULTS:
    Overall Survival

    Freedom from reoperation


    CONCLUSIONS:No significant differences could be demonstrated between the small-size numbers of the Mitroflow and the Carpentier Magna xenografts in the medium-term.However there are higher rates of overall mortality and reoperation in the longterm of patients who received a small-size Mitroflow prosthetic heart valve.The Mitroflow prosthesis should be used cautiously in patients with long life expectancy.


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