Key result
Larger Mitroflow valves show no late mortality benefit over smaller sizes and fare worse than Perimount.
Why the study?
The ACC guidelines recommend the same imaging frequency for all bioprosthetic valves, but some valves have demonstrated poor durability, prompting assessment of mortality differences between Mitroflow and Perimount valves.
Does Mitroflow aortic valve replacement affect all-cause mortality compared to Perimount aortic valve replacement in patients undergoing isolated surgical aortic valve replacement?
Observational (n=1,150)
Does Mitroflow aortic valve replacement affect all-cause mortality compared to Perimount aortic valve replacement in patients undergoing isolated surgical aortic valve replacement?
Absolute Event Rate: 66.7% vs 61.5%
p-value: p=0.95
Mitroflow aortic valves are associated with a poorer long-term prognosis compared to Perimount valves, regardless of the valve size used.
Mitroflow linked to higher mortality than Perimount independent of size; leaves open whether valve-specific surveillance should replace uniform bioprosthetic guidelines.
Objectives: The American College of Cardiology (ACC) guidelines recommend the same imaging frequency for all bioprosthetic valves, but some have demonstrated poor durability. We aimed to assess mortality differences between small (19–21 mm) and large (23–29 mm) in Mitroflow and Carpentier‐Edwards Perimount aortic valves. Methods: A retrospective observational study was conducted by all patients undergoing isolated surgical aortic valve replacement with Mitroflow or Perimount in Western Denmark between 1999 and 2014 and followed until January 2024. The primary endpoint was all‐cause mortality. Secondary endpoints were cardiovascular mortality and sudden cardiac death. A propensity score‐matched analysis was performed. Results: A total of 1150 patients were analyzed, with 496 (43%) receiving Mitroflow valves and 654 (57%) receiving Perimount valves. In the Mitroflow group, 108 (22%) had a valve size of 19–21 mm, and 388 (78%) in the size range of 23–29 mm. In the Perimount group, the distribution was 99 (15%) and 555 (85%), respectively. The compromised survival of Mitroflow valves was attributed to the valve type, regardless of the valve sizes. Larger Mitroflow valves exhibited the same compromised late mortality as smaller valves, 66.7% vs 61.5%, respectively (p = 0.95). The same pattern of mortality was observed in the matched population, with Perimount demonstrating significant lower risk of mortality. Conclusion: Mitroflow valves were associated with a poorer prognosis compared to Perimount valves. Additionally, larger Mitroflow valves were not associated with an improved prognosis compared to smaller valve sizes. EuroSCORE2 had a significant impact on patient survival.
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Krasniqi et al. (2024) conducted an observational in Isolated surgical aortic valve replacement (n=1,150). Large Mitroflow aortic valves (23-29 mm) vs. Small Mitroflow aortic valves (19-21 mm) was evaluated on all-cause mortality (p=0.95). Larger Mitroflow aortic valves were not associated with improved late mortality compared to smaller valves (66.7% vs 61.5%, p=0.95), and Mitroflow valves overall had poorer prognosis than Perimount.
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