Mid-term hemodynamic and clinical results of the stented porcine medtronic mosaic valve in aortic position.

BACKGROUND: Our study aim was to evaluate the hemodynamic and clinical performance of the Mosaic bioprosthesis in aortic position.

METHODS: The stented porcine bioprosthesis combines zero pressure glutaraldehyde fixation and amino oleic acid antimineralization treatment for improved hemodynamics and durability. Between 2/1994 and 5/1999, 100 patients underwent aortic valve replacement. Mean age at implant was 73.4 years. Patients were followed up within thirty days after intervention, after six months and then annually. Mean follow-up was 4.8 years (range 0.1-8.8 years), totaling 483.4 patient-years.

RESULTS: Mortality within 30 days was 3.0 %; late mortality was 4.6%/patient-year, including 0.4 %/patient-year prosthesis-related mortality. Freedom from event rates at 8.5 years were 96.8% for thromboembolism, 97.7% for thrombosed bioprosthesis, 97.4% for structural deterioration, 98.7% for nonstructural dysfunction, 95.9 % for hemorrhage, 98.9% for endocarditis and 95.1 % for reoperation and explant. Mean pressure gradients were 15.2 mm Hg (21), 14.5 mm Hg (23), 12.7 mm Hg (25) and 13.0 mm Hg (27) after one year; effective orifice areas 1.36 cm2 (21), 1.68 cm2 (23), 1.76 cm2 (25) and 2.57 cm2 (27).

CONCLUSIONS: Clinical and hemodynamic performance of the Mosaic bioprosthesis was highly satisfactory during the first 8.5 years after clinical introduction.