Mid-Term Hemodynamic and Clinical Results of the Stented Porcine Medtronic Mosaic Valve in Aortic Position[*]

Abstract

Background: Our study aim was to evaluate the hemodynamic and clinical performance of the Mosaic bioprosthesis in aortic position. Methods: The stented porcine bioprosthesis combines zero pressure glutaraldehyde fixation and amino oleic acid antimineralization treatment for improved hemodynamics and durability. Between 2/1994 and 5/1999, 100 patients underwent aortic valve replacement. Mean age at implant was 73.4 years. Patients were followed up within thirty days after intervention, after six months and then annually. Mean follow-up was 4.8 years (range 0.1 - 8.8 years), totaling 483.4 patient-years. Results: Mortality within 30 days was 3.0 %; late mortality was 4.6 %/patient-year, including 0.4 %/patient-year prosthesis-related mortality. Freedom from event rates at 8.5 years were 96.8 % for thromboembolism, 97.7 % for thrombosed bioprosthesis, 97.4 % for structural deterioration, 98.7 % for nonstructural dysfunction, 95.9 % for hemorrhage, 98.9 % for endocarditis and 95.1 % for reoperation and explant. Mean pressure gradients were 15.2 mm Hg (21), 14.5 mm Hg (23), 12.7 mm Hg (25) and 13.0 mm Hg (27) after one year; effective orifice areas 1.36 cm² (21), 1.68 cm² (23), 1.76 cm² (25) and 2.57 cm² (27). Conclusions: Clinical and hemodynamic performance of the Mosaic bioprosthesis was highly satisfactory during the first 8.5 years after clinical introduction.

Key words

Aortic valve replacement - heart valve bioprosthesis - AOA - zero pressure - structural valve deterioration

1 Presented at the 32nd Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery in Leipzig/Germany in February 2003.

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1 Presented at the 32nd Annual Meeting of the German Society for Thoracic and Cardiovascular Surgery in Leipzig/Germany in February 2003.