Mid-term outcomes and hemodynamic performances of Abbott Epic mitral bioprosthesis: a single-center study.

OBJECTIVE

This study aimed to report "real-world" mid-term clinical experiences and outcomes after surgical mitral valve replacement with the Epic bioprosthesis in a high-volume Japanese heart center.

METHODS

Patients undergoing surgical mitral valve replacement with the Epic bioprosthesis from 2012 to 2023 were enrolled. Postoperative outcomes, survival, and hemodynamic performance were analyzed. The study endpoints were all-cause mortality, freedom from mitral valve reintervention, and major adverse cardiac events.

RESULTS

A total of 122 patients (mean age: 73 ± 8 years, 73 males) successfully underwent surgical mitral valve replacement with the Epic bioprosthesis (25 mm, n = 22; 27 mm, n = 37; 29 mm, n = 26; and 31 mm, n = 37). The primary valve etiologies were infective endocarditis (n = 17), stenosis (n = 18), stenosis and regurgitation (n = 13), regurgitation (n = 73), and thrombosis (n = 1). The median follow-up period was 33 (interquartile range: 20-48) months. Overall survival rates at 1, 3, and 5 years after mitral valve replacement were 86.8%, 82.0%, and 76.9%. The rates of freedom from rehospitalization for heart failure were 96.7% at 1 year, 95.5% at 3 years, and 91.2% at 5 years. The mean pressure gradient was 5 (interquartile range: 4-6.4) mmHg at discharge, 5.4 (interquartile range: 4.3-6.9) mmHg at 1 year, and 5.4 (interquartile range: 4-7.5) mmHg at late follow-up (Friedman test, p = 0.46). During the study period, only one patient required reintervention because of valve deterioration at 31 postoperative months.

CONCLUSION

The clinical outcomes of mitral valve replacement with the Epic bioprosthesis are satisfactory, with stable hemodynamics and extremely low incidence of structural valve deterioration and reintervention over 5 years.