The Italian study of the Mitroflow postoperative results (ISTHMUS): a 20-year, multicenter evaluation of Mitroflow pericardial bioprosthesis
| Autor: | ISTHMUS Investigators, Lorusso, R, Gelsomino, S, De Cicco, G, Vizzardi, E, Faggiano, P, Carella, R, Billè, G, Teodori, G, Caimmi, P, Dato, GA, Casabona, R, Welter, L, De Paulis, R, Calafiore, AM, Di Mauro, M, Di Credico, G, Leva, C, Messina, A, Villa, E, Troise, G, Borghetti, V, Pardini, A, Medici, D, Sala, A, Citterio, E, Barbone, A, Vitali, E, Tarelli, G, FORMICA, FRANCESCO, PAOLINI, GIOVANNI |
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| Přispěvatelé: | Isthmus, I, Lorusso, R, Gelsomino, S, De Cicco, G, Vizzardi, E, Faggiano, P, Carella, R, Billè, G, Teodori, G, Caimmi, P, Dato, G, Casabona, R, Welter, L, De Paulis, R, Calafiore, A, Di Mauro, M, Di Credico, G, Leva, C, Messina, A, Villa, E, Troise, G, Borghetti, V, Pardini, A, Medici, D, Sala, A, Citterio, E, Barbone, A, Vitali, E, Tarelli, G, Formica, F, Paolini, G |
| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male Reoperation medicine.medical_specialty Pediatrics medicine.medical_treatment Aortic Valve Insufficiency Prosthesis Design Prosthesis Interquartile range medicine Postoperative results Endocarditis Humans Mitroflow biologica valve aortic valve Coronary Artery Bypass Aged Aged 80 and over Bioprosthesis Heart Valve Prosthesis Implantation business.industry General Medicine Aortic Valve Stenosis medicine.disease Surgery Prosthesis Failure MED/23 - CHIRURGIA CARDIACA medicine.anatomical_structure Treatment Outcome Embolism Italy Cardiothoracic surgery Concomitant Aortic Valve Heart Valve Prosthesis Female Cardiology and Cardiovascular Medicine business Epidemiologic Methods Pericardium Artery |
| Popis: | Objective: A multicentre experience with the Mitroflow pericardial bioprosthesis has been evaluated longitudinally over a 20-year period. Methods: From 1988 through 2008, 1591 patients (mean age, 75.3 ± 6.8 years, and 60.1% female) from 12 centres had a Mitroflow in the aortic position. Concomitant coronary artery bypass was performed in 41.9% (n = 666) of patients, urgency/emergency surgery in 9.5% (n = 152) and replacement of degenerated prosthesis in 2.3% (n = 36). Follow-up (7.447 patient-years) was 99.2% complete. Median follow-up was 61.9 months (interquartile range (IQR) 30.8-90.9 months). The study was carried out following American Association for Thoracic Surgery/Society for Thoracic Surgeons/European Association for Cardio-Thoracic Surgery (AATS/STS/EACTS) Guidelines for reporting valve morbidity and mortality. Results: The early (30-day) mortality was 6.5% (n = 104). Actuarial survival rates at 10, 15 and 18 years were 53%, 34% and 27%, respectively (2.2 patient/year). Re-operation was required in 96 patients (5.9%), of whom 59 patients (3.7%) for structural valve degeneration. Actuarial freedom from prosthetic valve degeneration at 18 years was 65.5% (78% in patients >70 years) with a linearised rate of 1.4 patient/year (0.8 patient/year in patients >70 years). At 18 years, freedom from embolism was 82% (0.9 patient/year), freedom from valve endocarditis was 89% (0.6 patient/year) and freedom from bleeding episodes was 95% (0.2 patient/year), respectively. Conclusions: This independent multicentre study indicates that the Mitroflow pericardial bioprosthesis provides favourable long-term postoperative results with a low rate of valve-related events and need of re-intervention, particularly in patients older than 70 years. |
| Databáze: | OpenAIRE |
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