Ten-Year Follow-Up of Mitral Valve Replacement with the Epic Porcine Valve in a Medicare Population.

Autor:	Rodriguez E; Ascension Saint Thomas Hospital, Cardiac Surgery, Nashville, Tennessee. Electronic address: evelio.rodriguez@ascension.org., Smith R; Baylor Scott & White The Heart Hospital, Division of Cardiothoracic Surgery, Plano, Texas., Castro L; Sequoia Hospital, Redwood City, California., Baker CJ; Keck Hospital of the University of Southern California, Division of Cardiac Surgery, Los Angeles, California., Yu Y; Abbott, Santa Clara, California., Prillinger JB; Abbott, Santa Clara, California., Gutfinger D; Abbott, Santa Clara, California., Starnes VA; Keck Hospital of the University of Southern California, Division of Cardiac Surgery, Los Angeles, California.
Jazyk:	angličtina
Zdroj:	The Annals of thoracic surgery [Ann Thorac Surg] 2024 Aug 13. Date of Electronic Publication: 2024 Aug 13.
DOI:	10.1016/j.athoracsur.2024.07.032
Abstrakt:	Background: Bioprosthetic surgical mitral valve replacement (SMVR) remains an important treatment option in the era of transcatheter valve interventions. We present 10-year clinical outcomes of Medicare beneficiaries undergoing SMVR with a contemporary low-profile mitral porcine valve. Methods: This is a single-arm observational study using Medicare fee-for-service claims data. De-identified patients undergoing SMVR with the Epic™ Mitral valve (Abbott, Minnesota, USA) in the United States between 1/1/2008-12/31/2019 were selected by ICD-9/10 procedure codes and then linked to a manufacturer device tracking database. All-cause mortality, heart failure (HF) re-hospitalization, and mitral valve reintervention (surgical or transcatheter valve-in-valve) were evaluated at 10-years using the Kaplan Meier method. Results: Among 75,739 Medicare beneficiaries undergoing SMVR during the study period, 14,015 were implanted with the Epic™ Mitral valve, of which 76.5% (10,720) had underlying HF. Mean age was 74±8 years. Survival at 10-years in patients without preoperative HF was 40.4% (95% CI 37.4%-43.4%) compared to 25.4% (95% CI 23.8%-27.0%) for patients with HF (p < 0.001). The 10-year freedom from HF rehospitalization was 51.3% (95% CI 49.4%-53.1%). Freedom from mitral valve reintervention was 91.4% (95% CI 89.7%-92.7%) at 10 years. Conclusions: This real-world nationwide study of Medicare beneficiaries receiving the Epic™ Mitral valve demonstrates >90% freedom from all-cause valve reintervention and >50% freedom from HF rehospitalization at 10-years post-implant. Long-term survival and HF rehospitalization in this population with mitral valve disease undergoing SMVR was found to be impacted by underlying HF. (Copyright © 2024. Published by Elsevier Inc.)
Databáze:	MEDLINE
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