Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier–Edwards PERIMOUNT pericardial valve†

Bourguignon, Thierry; Espitalier, Fabien; Pantaleon, Clémence; Vermès, Emmanuelle; El-Arid, Jean Marc; Loardi, Claudia; Karam, Elias; Candolfi, Pascal; Ivanès, Fabrice; Aupart, Michel

doi:10.1093/ejcts/ezy029

Cited by 36 publications

(25 citation statements)

References 25 publications

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“…Hence, they can show a slightly higher average age [ 10 , 14 ] . Studies carried out on samples with rheumatic being the most prevalent etiology show lower averages, as well as that found in the present study [ 16 , 17 ] .…”

Section: Discussionsupporting

confidence: 88%

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Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Moreira

Barletta

Baucia

2021

Braz J Cardiovasc Surg

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Introduction We aimed to identify predictors of morbidity and mortality in patients undergoing isolated mitral valve replacement. Methods This is a retrospective cohort study with 164 patients who underwent isolated mitral valve replacement at a referral hospital for cardiovascular diseases, which were performed from January 2011 to December 2016. Data were obtained from medical records, including preoperative, intraoperative, and postoperative information. Statistical analysis was performed to calculate odds ratio (OR), unpaired Student's t -test, and binary logistic regression. P -values < 0.05 were considered significant. Results A total of 69.5% (n=114) of the patients had a diagnosis of rheumatic disease prior to surgery. Mortality rate was 6.7% (n=11). The most observed complication was the occurrence of postoperative arrhythmias (19.5%). On average, patients remained 5.34 days in the intensive care unit. There was a statistically significant enhanced risk of death among patients with previous diagnosis of endocarditis (OR 5.22, 95% confidence interval [CI] 1,368-19,915; P =0.008), reduced ejection fraction (EF) (< 50%) (OR 9.46, 95% CI 2,61-34,35; P <0.001), and mitral regurgitation (MR) (OR 7.7, 95% CI 1.576-37.545; P =0.004). Patients who died were older than those who survived surgery ( P <0.001) and had lower preoperative serum hemoglobin levels ( P =0.018). Logistic regression showed age and reduced EF at preoperative evaluation as predictors of death. Conclusion Older age, reduced serum hemoglobin levels, preoperative diagnosis of endocarditis, reduced EF, and MR were associated with postoperative mortality. Age and reduced EF were predictors of death.

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Section: Discussionsupporting

confidence: 88%

“…The Global Rheumatic Heart Disease Registry, or the REMEDY study [ 2 ] , and Remenyi, ElGuindy, Smith, Yacoub, and Holmes [ 4 ] also showed a predominance of this sex among the total affected by rheumatic disease, whether in developed countries or not. Most studies on mitral surgery have a mostly female population [ 10 - 17 ] .…”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Moreira

Barletta

Baucia

2021

Braz J Cardiovasc Surg

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“…If uncontrolled, SVD critically impairs the functioning of the implanted valve, causing recurrent stenosis or insufficiency [ 6 , 7 , 8 ]. In spite of the current advances in the design and manufacturing of BHVs, SVD remains a common long-term complication [ 9 , 10 , 11 ] demanding a repeated valve replacement in half of the patients 15 years post-implantation [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Ultrastructural Pathology of Atherosclerosis, Calcific Aortic Valve Disease, and Bioprosthetic Heart Valve Degeneration: Commonalities and Differences

Kostyunin

Mukhamadiyarov

Глушкова

et al. 2020

IJMS

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Atherosclerosis, calcific aortic valve disease (CAVD), and bioprosthetic heart valve degeneration (alternatively termed structural valve deterioration, SVD) represent three diseases affecting distinct components of the circulatory system and their substitutes, yet sharing multiple risk factors and commonly leading to the extraskeletal calcification. Whereas the histopathology of the mentioned disorders is well-described, their ultrastructural pathology is largely obscure due to the lack of appropriate investigation techniques. Employing an original method for sample preparation and the electron microscopy visualisation of calcified cardiovascular tissues, here we revisited the ultrastructural features of lipid retention, macrophage infiltration, intraplaque/intraleaflet haemorrhage, and calcification which are common or unique for the indicated types of cardiovascular disease. Atherosclerotic plaques were notable for the massive accumulation of lipids in the extracellular matrix (ECM), abundant macrophage content, and pronounced neovascularisation associated with blood leakage and calcium deposition. In contrast, CAVD and SVD generally did not require vasculo- or angiogenesis to occur, instead relying on fatigue-induced ECM degradation and the concurrent migration of immune cells. Unlike native tissues, bioprosthetic heart valves contained numerous specialised macrophages and were not capable of the regeneration that underscores ECM integrity as a pivotal factor for SVD prevention. While atherosclerosis, CAVD, and SVD show similar pathogenesis patterns, these disorders demonstrate considerable ultrastructural differences.

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“…Because patients with rheumatic heart disease are relatively young, the main feature of the group is younger patients underwent MVR. Moreover, 84.86% of the patients were classified as NYHA class III or above, and 19.37% were diagnosed as NYHA class IV before valve replacement, suggesting a worse preoperative cardiac condition in Chinese patients than in European and American patients (11)(12)(13).…”

Section: Discussionmentioning

confidence: 99%

“…Even considering the level of healthcare service, the severity of patient condition at first visit, patient awareness of self-care, and economic conditions in China, survival analysis showed that the 10-year survival rate is satisfied compared to its foreign counterparts on average, especial in AVR and DVR (12)(13)(14)(15). The more comparable result is from Chinese local patients replaced with Perimount bovine pericardial bioprosthetic valves (14).…”

Section: Discussionmentioning

confidence: 99%

A single-center 14-year follow-up study of the BalMedic® bovine pericardial bioprosthetic valve

Lin¹,

Gan²,

Lv³

et al. 2020

Ann Transl Med

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Background: The causes of valvular disease in China are complex, with a broad age distribution.For patients with early mechanical valve replacement, the quality of life is affected by postoperative anticoagulation-related complications. Since 2005, we have used bioprosthetic valves to provide more options for patients. In this study, we retrospectively analyzed the 14-year follow-up data of patients undergoing BalMedic bovine pericardial bioprosthetic valve replacement (manufacturer: Beijing Balance Medical Tech Co., Ltd.) to evaluate its intermediate-to long-term clinical effectiveness. Methods: From 2005 to 2014, 336 BalMedic pericardial bioprosthesis valves were implanted in 299 patients (mean age 53.5 years, 59.86% female) at The First People's Hospital of Yulin. Among followed up 290 discharged patients, 284 underwent aortic valve replacement and mitral valve replacement (AVR group, MVR group) for further grouping analysis, 6 underwent tricuspid valve replacement (TVR). The mean follow-up was 7.7±2.5 years (5 to 14), for a total of 2,196 valve-years, 98.28% of the patients completed follow-up.Results: The perioperative mortality was 3% (9/299). After discharge, 68 patients (23.4%, 68/290) died, and 36 (12.4% 36/290) underwent the second valve replacement. The overall 5-and 10-year survival rates were 89.95% and 72.53%, respectively. For patients undergoing AVR alone, the overall 10-year survival rates were 80.64%, the reoperation-free rates were 92.94%, and the SVD-free rates were 90.95%. For patients undergoing MVR and double valve replacement (DVR group), the 10-year survival rates were 67.21% and 82.90%, the reoperation-free rates were 72.26% and 73.33%, the SVD-free rates were 58.90% and 53.80%, respectively. Subgroup analysis by age showed no significant intergroup difference in overall survival but a significant intergroup difference in reoperation-free and SVD-free rates (P<0.05).Conclusions: With a similar 10-year overall survival rate as its foreign counterparts, BalMedic bovine pericardial bioprosthesis is reliable choice for both aortic valve and mitral valve. In patients undergoing AVR, the BalMedic valve is superior to the similar foreign counterparts in overall survival, reoperation-free survival, and SVD-free rates. While in MVR or DVR, Chinese patients are younger because of different etiology, postoperative outcomes show non-inferior to those from the foreign counterparts.

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Bioprosthetic mitral valve replacement in patients aged 65 years or younger: long-term outcomes with the Carpentier–Edwards PERIMOUNT pericardial valve†

Abstract: In the selected patients aged 65 years or younger undergoing mitral valve replacement with a pericardial bioprosthesis, the expected valve durability was 14.2 years. Reoperation for SVD was associated with a low risk of mortality.

Cited by 36 publications

References 25 publications

Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Ultrastructural Pathology of Atherosclerosis, Calcific Aortic Valve Disease, and Bioprosthetic Heart Valve Degeneration: Commonalities and Differences

A single-center 14-year follow-up study of the BalMedic® bovine pericardial bioprosthetic valve

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