European experience with the Mosaic bioprosthesis

Eichinger, Walter; Botzenhardt, Florian; Günzinger, Ralf; Kemkes, B. M.; Sosnowski, Andrzej; Maïza, D; Coto, Eduardo Otero; Bleese, Niels

doi:10.1067/mtc.2002.122552

Cited by 44 publications

(36 citation statements)

References 17 publications

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“…Extrapolating the results of this in vivo study by the reported durability of the Perimount and Mosaic bioprostheses in humans, 26,27 the PCU valves are expected to have a considerably longer freedom from valve related reoperation.…”

Section: Discussionmentioning

confidence: 99%

Introduction of a Flexible Polymeric Heart Valve Prosthesis With Special Design for Mitral Position

et al. 2003

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Background-Current heart valve prostheses are constructed mimicking the native aortic valve. Special hemodynamic characteristics of the mitral valve such as a nonaxial central inflow with creation of a left ventricular vortex have so far not been taken into account. A new polycarbonaturethane (PCU) bileaflet heart valve prosthesis with special design for the mitral position is introduced, and results of animal testing are presented. Methods and Results-After in vitro testing, 7 PCU-prostheses and 7 commercial bioprostheses (Perimount, nϭ4; Mosaic, nϭ3) were implanted in mitral position into growing Jersey calves (age 3-5 months, weight 60 -97 kg) for 20 weeks. 2-Dimensional echocardiography was performed after implantation and before sacrification. Autopsy included histologic, radiographic, and electron microscopic examination of the valves. In vitro durability was proven for Ͼ15 years. After implantation 2-dimensional-echocardiography showed no relevant gradient or regurgitation of any prosthesis. Clinical course of the animals with PCU valves was excellent. In contrast, 5 of 7 calves with bioprostheses were sacrificed after 1-9 weeks because of congestive heart failure. 2-Dimensional echocardiography of the PCU valves after 20 weeks showed mild leaflet thickening with trivial regurgitation; mean gradient was 8.1Ϯ5.0 mm Hg (weight: 160 -170 kg). The explanted PCU prostheses revealed mild calcification and no structural degeneration. All of the Perimount bioprostheses were severely calcified and degenerated after 11Ϯ7 weeks. One Mosaic bioprosthesis was thrombosed after 1 week, and 2 showed severe and mild-to-moderate degeneration after 4 and 22 weeks, respectively. Conclusions-Polycarbonaturethane

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Section: Discussionmentioning

confidence: 99%

Introduction of a Flexible Polymeric Heart Valve Prosthesis With Special Design for Mitral Position

et al. 2003

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“…[6][7][8][9]19 Data concerning the long-term performance of the MB have been presented by Riess and colleagues 10,20 and, more recently, by Celiento and associates, 11 who reported a 10-to 13-year follow-up. Indeed, most of the data currently available concerning the MB refer to patients after AVR, whereas the performance of the MB after MVR has been evaluated mostly in multicenter studies, with short follow-up reports.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, most of the data currently available concerning the MB refer to patients after AVR, whereas the performance of the MB after MVR has been evaluated mostly in multicenter studies, with short follow-up reports. [6][7][8][9]21 Recently, however, Jamieson and co-authors 22 have published a multicenter study of the MB after MVR, which is the only study to exceed ours in the number of patients reported. These Valve-related sequelae 9 1.47 ± 0.49 95 ± 2 82 ± 7 82 ± 7 pt-yr = patient-year Unless otherwise stated, data are presented as number or as percentage ± 95% SE.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] The Mosaic ® bioprosthesis (MB) (Medtronic, Inc.; Minneapolis, Minn) is a 3rd-generation porcine valve that became clinically available in 1994. Various reports [6][7][8][9] have shown that the MB is a safe and well-performing device in the medium and intermediate terms. More recently, data on the 13-year follow-up evaluation of the MB-when used for aortic valve replacement (AVR)-have become available.…”

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confidence: 99%

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The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

Celiento¹,

Blasi²,

Martino³

et al. 2016

Texas Heart Institute Journal

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We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P <0.0001). Thromboembolic episodes occurred in 4 patients, with an actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm2; in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm2. During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement.

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“…There are different types of bioprosthetic valves for humans, including Hancock II bioprostheses (porcine bioprosthesis), Carpentier-Edwards bovine pericardial valves and Mosaic bioprosthesis (porcine bioprosthesis); the longterm prognoses of these valves have been reported only in human medicine [4,6]. Glutaraldehyde has been widely used as a tissue fixative for these bioprosthetic valves and vascular grafts due to its ability to produce collagen crosslinking, reduce tissue antigenicity and sterilize the valves [27].…”

Section: Discussionmentioning

confidence: 99%

Short-Term Performance of Mitral Valve Replacement with Porcine Bioprosthetic Valves in Dogs

Takashima¹,

Soda

Tanaka

et al. 2007

The Journal of Veterinary Medical Science

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ABSTRACT. Porcine bioprosthetic valves cross-linked with glutaraldehyde and polyepoxy compound were newly developed for mitral valve replacement (MVR) in dogs. Five beagle dogs were performed a left thoracotomy and underwent MVR using the porcine bioprosthetic valves during cardiopulmonary bypass (CPB). A vein catheter inserted into right atrium and a vent catheter inserted into the right ventricle to drain. The hemodynamic conditions of CPB were excellent during surgery. The left atrial pressure was measured before and after MVR; there was no significant difference and it was normal. Thrombosis and the prosthetic valve regurgitation were not observed one week after MVR. Pressure half time (PHT) prolonged significantly (P<0.05) from 31.40 ± 4.0 msec presurgery to 99.20 ± 19.4 msec at seven days after MVR, although it indicated the normal range as the bioprosthetic valve. The symptom of the prosthetic valve failure was not observed. This study indicated that the MVR using porcine bioprosthetic valves under CPB might have been effective in dogs as a short-term evaluation. KEY WORDS: bioprosthetic valve, canine cardiopulmonary bypass, mitral regurgitation, mitral valve replacement.

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European experience with the Mosaic bioprosthesis

Abstract: Clinical and hemodynamic performance of the Mosaic bioprosthesis were very satisfactory during the first 6 years after clinical introduction.

Cited by 44 publications

References 17 publications

Introduction of a Flexible Polymeric Heart Valve Prosthesis With Special Design for Mitral Position

Introduction of a Flexible Polymeric Heart Valve Prosthesis With Special Design for Mitral Position

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

Short-Term Performance of Mitral Valve Replacement with Porcine Bioprosthetic Valves in Dogs

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