Abstract
Background The Mitroflow pericardial bioprosthesis (MPB) has been recently associated with a
high incidence of early structural failures, questioning its validity as cardiac valve
substitute. We have therefore reviewed our experience with this device.
Materials and Methods A total of 398 patients with a mean age of 75 ± 7 years (58% above the age of 75
years) had aortic valve replacement with a Mitroflow prosthesis (2005–2015). Most
patients had calcific aortic stenosis (86%) and were in sinus rhythm (89%). Mean EuroSCORE
II was 5.5 ± 6.2. Mean follow-up was 4 ± 2 years (range: 4 months to 10 years), which
was 100% complete.
Results Hospital mortality was 6.5%; at discharge, 25% of patients had a moderate patient–prosthesis
mismatch and none had a severe mismatch. Cumulative incidence of structural valve
deterioration in the entire series was 2% (95% confidence interval [CI]: 1–4) at 5
years and 7% (95% CI: 4–14) at 8 years. Significant factors influencing MPB durability
were age ≤ 65 years (p < 0.001) and the presence of patient–prosthesis mismatch (p = 0.01). No cases of structural valve deterioration were observed in patients with
the new prosthetic model incorporating an anticalcification treatment the first 4
years of follow-up.
Conclusions The Mitroflow prosthesis has shown satisfactory results in the first decade of use.
Durability appears adversely influenced by patient age and patient–prosthesis mismatch.
Thus, a careful valve size selection and implantation in patients >65 years of age
appears to be associated with excellent valve durability in the aortic position. Whether
the new anticalcification treatment will provide a more durable prosthesis must be
verified at a longer follow-up.
Keywords
aortic valve - aortic valve replacement - bioprosthesis
