Anton Tomšič MD, PhD , Mateo Marin-Cuartas MD , Manuela De La Cuesta MD , Wolfgang Otto MSc , Paul T. Bräuchle MD , Bettina Pfannmüller MD, PhD , Philipp Kiefer MD , Martin Misfeld MD, PhD , Sergey Leontyev MD, PhD , Michael A. Borger MD, PhD , Thilo Noack MD, PhD
{"title":"使用 Epic 和 Mosaic 生物人工瓣膜进行二尖瓣置换术后的临床疗效","authors":"Anton Tomšič MD, PhD , Mateo Marin-Cuartas MD , Manuela De La Cuesta MD , Wolfgang Otto MSc , Paul T. Bräuchle MD , Bettina Pfannmüller MD, PhD , Philipp Kiefer MD , Martin Misfeld MD, PhD , Sergey Leontyev MD, PhD , Michael A. Borger MD, PhD , Thilo Noack MD, PhD","doi":"10.1016/j.atssr.2023.11.032","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Comparative studies of outcomes between different biological mitral valve prostheses are scarce. This study compares the late clinical results of valve replacement with the Epic and Mosaic bioprostheses.</p></div><div><h3>Methods</h3><p>Patients undergoing isolated elective mitral valve replacement (MVR) between 2005 and 2019 were eligible for inclusion. Primary outcomes were freedom from mitral valve reintervention and overall survival. Inverse probability of treatment weighting and competing risk analyses were performed.</p></div><div><h3>Results</h3><p>MVR was performed in 247 (73.7%) patients with the Epic prosthesis and in 88 (26.3%) patients with the Mosaic prosthesis. The median follow-up was 3 (interquartile range, 0.20-5.64) years. At 10 years postoperative, the estimated survival rates were 86.1% (95% CI, 80.5%-91.9%) and 73.5% (95% CI, 60.6%-89.3%) for the Epic and Mosaic groups, respectively (<em>P</em> = .40). On inverse probability of treatment weighted analysis, no significant intergroup difference was found (hazard ratio, 1.20; 95% CI, 0.54-2.66; <em>P</em> = .70]. At 10 years, the cumulative incidence functions of mitral valve reintervention with death as competing risk were 34.4% (95% CI, 32.7%-36.1%) and 17.6% (95% CI, 16.2%-18.9%) for the Epic and Mosaic groups, respectively. On multivariable Fine-Gray analysis, the type of implanted mitral valve prosthesis just failed to reach a statistically significant difference in mitral valve reintervention (hazard ratio, 0.43 for Mosaic valve; 95% CI, 0.18-1.06; <em>P</em> = .067). Structural valve deterioration was an uncommon indication for reintervention in the first 10 years postoperative.</p></div><div><h3>Conclusions</h3><p>Clinical results of MVR with the Epic or Mosaic prosthesis are satisfactory. Our results suggest that the Mosaic bioprosthesis might offer better freedom from reintervention.</p></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S277299312300387X/pdfft?md5=91c6b0b7484de2aaff6c63d3ba65e1f5&pid=1-s2.0-S277299312300387X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Clinical Outcomes After Mitral Valve Replacement With Epic and Mosaic Bioprosthetic Valves\",\"authors\":\"Anton Tomšič MD, PhD , Mateo Marin-Cuartas MD , Manuela De La Cuesta MD , Wolfgang Otto MSc , Paul T. Bräuchle MD , Bettina Pfannmüller MD, PhD , Philipp Kiefer MD , Martin Misfeld MD, PhD , Sergey Leontyev MD, PhD , Michael A. Borger MD, PhD , Thilo Noack MD, PhD\",\"doi\":\"10.1016/j.atssr.2023.11.032\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Comparative studies of outcomes between different biological mitral valve prostheses are scarce. This study compares the late clinical results of valve replacement with the Epic and Mosaic bioprostheses.</p></div><div><h3>Methods</h3><p>Patients undergoing isolated elective mitral valve replacement (MVR) between 2005 and 2019 were eligible for inclusion. Primary outcomes were freedom from mitral valve reintervention and overall survival. Inverse probability of treatment weighting and competing risk analyses were performed.</p></div><div><h3>Results</h3><p>MVR was performed in 247 (73.7%) patients with the Epic prosthesis and in 88 (26.3%) patients with the Mosaic prosthesis. The median follow-up was 3 (interquartile range, 0.20-5.64) years. At 10 years postoperative, the estimated survival rates were 86.1% (95% CI, 80.5%-91.9%) and 73.5% (95% CI, 60.6%-89.3%) for the Epic and Mosaic groups, respectively (<em>P</em> = .40). On inverse probability of treatment weighted analysis, no significant intergroup difference was found (hazard ratio, 1.20; 95% CI, 0.54-2.66; <em>P</em> = .70]. At 10 years, the cumulative incidence functions of mitral valve reintervention with death as competing risk were 34.4% (95% CI, 32.7%-36.1%) and 17.6% (95% CI, 16.2%-18.9%) for the Epic and Mosaic groups, respectively. On multivariable Fine-Gray analysis, the type of implanted mitral valve prosthesis just failed to reach a statistically significant difference in mitral valve reintervention (hazard ratio, 0.43 for Mosaic valve; 95% CI, 0.18-1.06; <em>P</em> = .067). Structural valve deterioration was an uncommon indication for reintervention in the first 10 years postoperative.</p></div><div><h3>Conclusions</h3><p>Clinical results of MVR with the Epic or Mosaic prosthesis are satisfactory. 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Clinical Outcomes After Mitral Valve Replacement With Epic and Mosaic Bioprosthetic Valves
Background
Comparative studies of outcomes between different biological mitral valve prostheses are scarce. This study compares the late clinical results of valve replacement with the Epic and Mosaic bioprostheses.
Methods
Patients undergoing isolated elective mitral valve replacement (MVR) between 2005 and 2019 were eligible for inclusion. Primary outcomes were freedom from mitral valve reintervention and overall survival. Inverse probability of treatment weighting and competing risk analyses were performed.
Results
MVR was performed in 247 (73.7%) patients with the Epic prosthesis and in 88 (26.3%) patients with the Mosaic prosthesis. The median follow-up was 3 (interquartile range, 0.20-5.64) years. At 10 years postoperative, the estimated survival rates were 86.1% (95% CI, 80.5%-91.9%) and 73.5% (95% CI, 60.6%-89.3%) for the Epic and Mosaic groups, respectively (P = .40). On inverse probability of treatment weighted analysis, no significant intergroup difference was found (hazard ratio, 1.20; 95% CI, 0.54-2.66; P = .70]. At 10 years, the cumulative incidence functions of mitral valve reintervention with death as competing risk were 34.4% (95% CI, 32.7%-36.1%) and 17.6% (95% CI, 16.2%-18.9%) for the Epic and Mosaic groups, respectively. On multivariable Fine-Gray analysis, the type of implanted mitral valve prosthesis just failed to reach a statistically significant difference in mitral valve reintervention (hazard ratio, 0.43 for Mosaic valve; 95% CI, 0.18-1.06; P = .067). Structural valve deterioration was an uncommon indication for reintervention in the first 10 years postoperative.
Conclusions
Clinical results of MVR with the Epic or Mosaic prosthesis are satisfactory. Our results suggest that the Mosaic bioprosthesis might offer better freedom from reintervention.