Early Structural Valve Deterioration of Mitroflow Aortic Bioprosthesis

Abstract

Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

Standardized definitions of structural deterioration and valve failure in assessing long-term durability of transcatheter and surgical aortic bioprosthetic valves: a consensus statement from the European Association of Percutaneous Cardiovascular Interventions (EAPCI) endorsed by the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)

“…Porcine bioprostheses (Hancock II) have also demonstrated long-term durability in patients aged 60 years or older 16 while an accelerated pattern of SVD was observed with the Mitroflow prosthesis in approximately one-third of patients. 19 A study of 430 patients treated with a stentless bioprosthesis reported freedom from reoperation in 91.0% and 75.0% at 10 and 15 years, and freedom from reoperation for SVD in 95.9% and 82.3%, respectively. 17 Notably, outcomes vary with different surgical bioprostheses as demonstrated in recent post-market surveillance of 43 782 valves in England and Wales.…”

Transcatheter Aortic Valve-in-Valve Implantation for Patients With Degenerative Surgical Bioprosthetic Valves

“…4-6, 22 Early failure, however, is not rare. 23 The potential for earlier failure of surgical valves is evidenced by a relatively short median time to therapy in the global VIV registry of only 9 years (IQR, 6-12 years). 14 Mechanisms of failure include stenosis (due to calcification, or less commonly due to pannus or thrombosis) and regurgitation (due to wear and tear, calcification, or infection).…”

Direct Aortic Evolut R Implantation as Valve-In-Valve in a Patient Affected by Leriche Syndrome

“…Early degeneration or high gradient across a bioprosthesis in elderly patients has been rarely reported [4]. Structural valve deterioration includes changes intrinsic to the valve like wear, calcification, leaflet tear, and stent creep.…”