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10-years' experience of aortic valve replacement with the Mitroflow bioprosthesis

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Organization
Abstract
Objective: Recent reports raised concerns on the durability of the Mitroflow aortic bioprosthesis, especially for the LXA-model without anticalcification treatment. This study reflects a single-center experience with the Mitroflow for aortic valve replacement (AVR). Method: From June 2003 to December 2014, 634 patients underwent AVR with the Mitroflow prosthesis. The study focused on 510 consecutive patients that received the LXA-prosthesis (2003-2012), by addressing the end-points survival and prosthesis durability, with structural valve degeneration (SVD) defined by a mean transprosthetic gradient > 30 mmHg at echocardiography and/or need for reoperation. Results: The mean patient age was 76±6 years, with 14% < 70 y and 23% > 80 y. Valve sizes 23 and 25 were used in 70%, and 19 and 21 in only 18%, avoiding patient-prosthesis mismatch (PPM) in 91%. The mean follow-up time was 5.0±3.2 years, cumulating a total of 2152 patient-years (max 11.6 y). The 1-, 5-, and 8-year patient survival was 86±2%, 67±3%, and 47±3 % respectively. Freedom from SVD was 99±1% and 88±3 % at 5 and 8 years. Reoperation for SVD was performed in 3.3%, including redo-AVR (9) or TAVI (6) for cusp rupture (6) and stenotic calcified degeneration (9). Prosthetic explantation for endocarditis was done in 3 patients. No specific patient- nor prosthesis-related factors significantly affected valve durability. SVD was not observed with the more recent Mitroflow model-DLA with phospholipid reduction therapy (used since May 2012), within a maximal follow-up time of 2.8 y. Conclusion: Despite lacking anticalcification treatment, the LXA-generation Mitroflow bioprosthesis offered a reliable aortic valve substitute in patients older than 70 years. The low occurrence of PPM, enhanced by its specific design and a consistent supra-annular implantation technique, might have improved the valve durability. Further results with the Mitroflow model-DLA have to be awaited.
Keywords
AVR, aortic valve replacement, Mitroflow, anticalcification, structural valve degeneration, LXA

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Chicago
Verbeke, Jonas, Liesbeth Lootens, THOMAS MARTENS, FRANK CAES, Yves Van Belleghem, THIERRY BOVE, and Katrien Francois. 2015. “10-years’ Experience of Aortic Valve Replacement with the Mitroflow Bioprosthesis.” In BACTS 20th Congress, Abstracts. Belgian Association for Cardio-Thoracic Surgery (BACTS).
APA
Verbeke, Jonas, Lootens, L., MARTENS, T., CAES, F., Van Belleghem, Y., BOVE, T., & Francois, K. (2015). 10-years’ experience of aortic valve replacement with the Mitroflow bioprosthesis. BACTS 20th congress, Abstracts. Presented at the BACTS 20th Congress, Belgian Association for Cardio-Thoracic Surgery (BACTS).
Vancouver
1.
Verbeke J, Lootens L, MARTENS T, CAES F, Van Belleghem Y, BOVE T, et al. 10-years’ experience of aortic valve replacement with the Mitroflow bioprosthesis. BACTS 20th congress, Abstracts. Belgian Association for Cardio-Thoracic Surgery (BACTS); 2015.
MLA
Verbeke, Jonas, Liesbeth Lootens, THOMAS MARTENS, et al. “10-years’ Experience of Aortic Valve Replacement with the Mitroflow Bioprosthesis.” BACTS 20th Congress, Abstracts. Belgian Association for Cardio-Thoracic Surgery (BACTS), 2015. Print.
@inproceedings{6983086,
  abstract     = {Objective: Recent reports raised concerns on the durability of the Mitroflow aortic bioprosthesis, especially for the LXA-model without anticalcification treatment. This study reflects a single-center experience with the Mitroflow for aortic valve replacement (AVR).
Method: From June 2003 to December 2014, 634 patients underwent AVR with the Mitroflow prosthesis. The study focused on 510 consecutive patients that received the LXA-prosthesis (2003-2012), by addressing the end-points survival and prosthesis durability, with structural valve degeneration (SVD) defined by a mean transprosthetic  gradient {\textrangle} 30 mmHg at echocardiography and/or need for reoperation.
Results: The mean patient age was 76{\textpm}6 years, with 14\% {\textlangle} 70 y and 23\% {\textrangle} 80 y. Valve sizes 23 and 25 were used in 70\%, and 19 and 21 in only 18\%, avoiding patient-prosthesis mismatch (PPM) in 91\%. The mean follow-up time was 5.0{\textpm}3.2 years, cumulating a total of 2152 patient-years (max 11.6 y). The 1-, 5-, and 8-year patient survival was 86{\textpm}2\%, 67{\textpm}3\%, and 47{\textpm}3 \% respectively. Freedom from SVD was 99{\textpm}1\% and 88{\textpm}3 \% at 5 and 8 years. Reoperation for SVD was performed in 3.3\%, including redo-AVR (9) or TAVI (6) for cusp rupture (6) and stenotic calcified degeneration (9). Prosthetic explantation for endocarditis was done in 3 patients. No specific patient- nor prosthesis-related factors significantly affected valve durability. SVD was not observed with the more recent Mitroflow model-DLA with phospholipid reduction therapy (used since May 2012), within a maximal follow-up time of 2.8 y.
Conclusion: Despite lacking anticalcification treatment, the LXA-generation Mitroflow bioprosthesis offered a reliable aortic valve substitute in patients older than 70 years. The low occurrence of PPM, enhanced by its specific design and a consistent supra-annular implantation technique, might have improved the valve durability. Further results with the Mitroflow model-DLA have to be awaited.},
  author       = {Verbeke, Jonas and Lootens, Liesbeth and Martens, Thomas and Caes, Frank and Van Belleghem, Yves and Bov{\'e}, Thierry and Francois, Katrien},
  booktitle    = {BACTS 20th congress, Abstracts},
  language     = {eng},
  location     = {Brussels, Belgium},
  publisher    = {Belgian Association for Cardio-Thoracic Surgery (BACTS)},
  title        = {10-years' experience of aortic valve replacement with the Mitroflow bioprosthesis},
  year         = {2015},
}