Long-term Performance of Epic and PERIMOUNT Mitral Bioprostheses in Young Rheumatics

Objective: We compared the long-term cossmposites of valve-related reoperation, morbidity and mortality following two types of mitral bioprostheses in young rheumatics aged <45 years. Methods: Retrospective comparative analysis of structural valve-related reoperations, and survival data were performed on 260 propensity matched patients, undergoing bioprosthetic MVR between 2000 and 2019, using Epic (Group I, n=130) or PERIMOUNT bioprostheses (Group II, n=130). Results: The median age was 34.5 (IQR: 28-39) and 34 (IQR: 29-40) years for group I and II respectively. Hazard regression for mortality included HR (95% CI) preoperative congestive heart failure (CHF) 4.70 (1.76-12.56), p=0.002; renal failure 66.91 (12.88-347.59), p<0.0001; low left ventricular ejection fraction <0.25, 3.76 (1.72-7.27), p=0.004; and valve-related reoperations 3.82 (1.81-9.56), p=0.001. Although the structural valve degeneration (SVD)-related reoperations were more among the perimount group, propensity score matching did not exhibit any difference between the groups [8.5% (Group I) vs 14.6% (Group II), SMD -0.23, p=0.5]. At a median follow-up of 134 (IQR: 99.5-178.5) months, actuarial survival was 96.36%±0.01% (93.11-98.10), and there was no difference in survival between the groups (Log rank p=0.70). Conclusions: Both Epic and PERIMOUNT mitral bioprostheses provide similar long-term clinical outcomes and are an appealing alternative to mechanical prosthesis in younger rheumatics.