Key result
Perimount prosthesis achieves lower 1-year pressure gradients vs Mosaic despite similar EOA and clinical outcomes.
Why the study?
The hemodynamic and clinical outcomes following mitral valve replacement with the Perimount valve had not been directly compared with those of the Mosaic valve.
Does the Perimount bovine pericardial valve improve hemodynamic and clinical outcomes compared to the Mosaic porcine valve in patients undergoing mitral valve replacement for rheumatic heart disease?
RCT (n=145)
Does the Perimount bovine pericardial valve improve hemodynamic and clinical outcomes compared to the Mosaic porcine valve in patients undergoing mitral valve replacement for rheumatic heart disease?
Absolute Event Rate: 1.98% vs 1.89%
p-value: p=0.538
The Perimount bovine pericardial valve demonstrated superior early hemodynamic performance with lower pressure gradients compared to the Mosaic porcine valve at 1 year after mitral valve replacement, with comparable clinical outcomes.
Supports Perimount selection for mitral replacement in rheumatic disease; extends RCT data on pericardial versus porcine bioprostheses.
Background: To compare the hemodynamic and clinical outcomes following mitral valve replacement with the Perimount valve with those of the Mosaic valve. Methods: A total of 145 consecutive patients with rheumatic heart valve disease who underwent single bioprosthetic mitral valve replacement were randomized to receive either the Perimount (n=72) valve or the Mosaic bioprosthesis (n=73). The mean age of patients was 72.1 years (range, 58–89 years) with a sex distribution of 55.2% female and 44.8% male. Patients underwent follow up transthoracic echocardiography at 3 months and 1 year postoperatively. We compared demographics, preoperative clinical data, operative data, hemodynamic profiles, and clinical outcomes. Results: The cross-clamp time was similar, with 50.7±15.3 minutes for the Perimount and 50.7±21.8 minutes for the Mosaic bioprosthesis. The total bypass time was also similar, with 91.3±25.7 minutes for the Perimount and 87.8±25.6 minutes for the Mosaic valve. The peak and mean pressure gradients were lower in the Perimount group for all valve sizes and the difference was statistically significant at 1 year. The effective orifice area (EOA) was slightly larger in the Perimount valve (1.98±0.21 vs. 1.89±0.71 cm2, P=0.538) postoperatively, but there was no significant difference at 1 year. There were no differences in preoperative or postoperative left atrium diameter (LAD), left ventricular diastolic diameter (LVDD), left ventricular systolic diameter (LVSD), left ventricular ejection fraction (LVEF), pulmonary artery pressure (PAP). The mortality and major complications rate were similar between the two groups. Conclusions: The Perimount prostheses is superior to the Mosaic prostheses after mitral valve replacement, achieving statistically significant lower gradients and larger EOA when compared on the basis of manufacturer-labeled valve sizes. Both valves appear to provide satisfactory clinical results.
No takes yet. Share an insight, caveat, or question.
Fu et al. (2021) conducted an RCT in rheumatic heart valve disease (n=145). Perimount valve vs. Mosaic bioprosthesis was evaluated on Effective orifice area (EOA) postoperatively (p=0.538). The Perimount prosthesis achieved significantly lower pressure gradients at 1 year compared to the Mosaic prosthesis, with similar postoperative EOA (1.98 vs 1.89 cm2; P=0.538) and clinical outcomes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: