Mid-term outcomes and hemodynamic performances of Abbott Epic mitral bioprosthesis: a single-center study

OBJECTIVE: This study aimed to report "real-world" mid-term clinical experiences and outcomes after surgical mitral valve replacement with the Epic bioprosthesis in a high-volume Japanese heart center. METHODS: Patients undergoing surgical mitral valve replacement with the Epic bioprosthesis from 2012 to 2023 were enrolled. Postoperative outcomes, survival, and hemodynamic performance were analyzed. The study endpoints were all-cause mortality, freedom from mitral valve reintervention, and major adverse cardiac events. RESULTS: A total of 122 patients (mean age: 73 ± 8 years, 73 males) successfully underwent surgical mitral valve replacement with the Epic bioprosthesis (25 mm, n = 22; 27 mm, n = 37; 29 mm, n = 26; and 31 mm, n = 37). The primary valve etiologies were infective endocarditis (n = 17), stenosis (n = 18), stenosis and regurgitation (n = 13), regurgitation (n = 73), and thrombosis (n = 1). The median follow-up period was 33 (interquartile range: 20-48) months. Overall survival rates at 1, 3, and 5 years after mitral valve replacement were 86.8%, 82.0%, and 76.9%. The rates of freedom from rehospitalization for heart failure were 96.7% at 1 year, 95.5% at 3 years, and 91.2% at 5 years. The mean pressure gradient was 5 (interquartile range: 4-6.4) mmHg at discharge, 5.4 (interquartile range: 4.3-6.9) mmHg at 1 year, and 5.4 (interquartile range: 4-7.5) mmHg at late follow-up (Friedman test, p = 0.46). During the study period, only one patient required reintervention because of valve deterioration at 31 postoperative months. CONCLUSION: The clinical outcomes of mitral valve replacement with the Epic bioprosthesis are satisfactory, with stable hemodynamics and extremely low incidence of structural valve deterioration and reintervention over 5 years.