Key result
Redo surgery occurred earlier and more frequently in patients with the Mosaic porcine valve compared to the Perimount bovine pericardial valve (4.6% vs 2.1%; P=0.02).
Why the study?
Does the Medtronic Mosaic porcine prosthesis compared to the Carpentier-Edwards Perimount bovine pericardial prosthesis affect the rate of redo surgery in patients undergoing aortic valve replacement?
Observational (n=1,018)
No
Does the Medtronic Mosaic porcine prosthesis compared to the Carpentier-Edwards Perimount bovine pericardial prosthesis affect the rate of redo surgery in patients undergoing aortic valve replacement?
Early redo surgery for structural valve degeneration was uncommon but occurred earlier and more frequently for the Mosaic porcine valve compared to the Perimount bovine pericardial valve.
Answers are grounded in this paper and cite their sources.
Mosaic valve was associated with earlier redo surgery; this Level 3 evidence leaves open whether prosthesis choice affects durability and should not yet change practice.
OBJECTIVES: The objective of this study was to compare rates of redo surgery for the Medtronic Mosaic 305 A Porcine Prosthesis and the Carpentier-Edwards Perimount Pericardial Aortic Bioprosthesis 2900. METHODS: This was a single-centre retrospective observational study. We included all 1018 patients who underwent aortic valve replacement with a Mosaic (n = 216) or Perimount (n = 809) bioprosthesis between October 2000 and August 2008. The total follow-up was 1508 patient-years for the Mosaic valve and 5813 for the Perimount valve. The maximal follow-up and interquartile range were 14.8 and 7.0 years for the Mosaic valve and 15.1 and 5.6 years for the Perimount valve, respectively. A propensity score-weighted version of the Cox model, Kaplan-Meier analysis and multivariate regression model was used. RESULTS: Despite no statistical difference in the number of non-structural valve deterioration cases between valves, redo surgery occurred earlier in 10 (4.6%) Mosaic than for 17 (2.1%) Perimount valves (P = 0.02) and was required for structural valve deterioration in 5 (2.3%) Mosaic valves when compared with 7 (0.9%; P = 0.04) Perimount valves. Four of 5 Mosaic failures occurred before 5 years, whereas all Perimount failures occurred after 5 years. Redo surgery for non-structural valve deterioration occurred in 3 patients with Mosaic valves (1.4%) and no patients with Perimount valves. Surgery for the remaining patients with Perimount valves was due to infection or aortic disease. CONCLUSIONS: Early redo surgery for structural valve degeneration was uncommon but occurred earlier for the Mosaic porcine than the Perimount bovine pericardial replacement aortic valve.
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Webb et al. (2018) conducted an observational in Aortic valve replacement (n=1,018). Medtronic Mosaic 305 A Porcine Prosthesis vs. Carpentier-Edwards Perimount Pericardial Aortic Bioprosthesis 2900 was evaluated on Redo surgery (p=0.02). Redo surgery occurred earlier and more frequently in patients with the Mosaic porcine valve compared to the Perimount bovine pericardial valve (4.6% vs 2.1%; P=0.02).
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