Hemodynamic Performance of the Medtronic Mosaic Porcine Bioprosthesis Up to Ten Years

Rieß, Friedrich-Christian; Bader, Ralf; Cramer, Eva B.; Hansen, Lorenz; Kleijnen, B.; Wahl, G.; Wallrath, Jürgen; Winkel, S.; Bleese, Niels

doi:10.1016/j.athoracsur.2006.07.034

Cited by 46 publications

(32 citation statements)

References 25 publications

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“…[6][7][8][9]19 Data concerning the long-term performance of the MB have been presented by Riess and colleagues 10,20 and, more recently, by Celiento and associates, 11 who reported a 10-to 13-year follow-up. Indeed, most of the data currently available concerning the MB refer to patients after AVR, whereas the performance of the MB after MVR has been evaluated mostly in multicenter studies, with short follow-up reports.…”

Section: Discussionmentioning

confidence: 99%

“…No cases of SVD have been reported by Thomson and colleagues 6 or Eichinger and associates 7 at 4 years, by Fradet and coworkers at 7 years, 8 or by Riess and co-authors at 10 years. 20 Jamieson and associates, 19 months after MVR, observed one case of SVR caused by cusp tears with minimal calcification. 9 Given our extended follow-up period, our results can provide some meaningful information on the late durability of the MB in the mitral position.…”

Section: Discussionmentioning

confidence: 99%

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The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

Celiento¹,

Blasi²,

Martino³

et al. 2016

Texas Heart Institute Journal

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We reviewed the cases of 100 patients (mean age, 73 ± 10 yr; 64 men) who had mitral valve replacement with a Medtronic Mosaic porcine bioprosthesis from 1995 through 2011. The mean New York Heart Association (NYHA) class was 3 ± 0.7, and 52 patients were in atrial fibrillation. Prosthetic sizes were chiefly 27 mm (50 patients) and 29 mm (40 patients). Follow-up ended in December 2012 and is 97% complete, with a cumulative duration of 611 patient-years (mean duration, 6 ± 4.6 yr; maximum, 17.7 yr). The early mortality rate was 10% (6% in elective patients); late deaths occurred in 31 patients (5 valve-related). Actuarial survival rates at 5, 10, and 15 years were 74% ± 5%, 50% ± 6%, and 37% ± 8%. The mean NYHA class in survivors was 1.4 ± 0.6 (P <0.0001). Thromboembolic episodes occurred in 4 patients, with an actuarial freedom at 15 years of 91% ± 5%. No cases of endocarditis were observed. Four patients needed reoperation, 2 for structural failure, and 1 each for perivalvular leakage and valve thrombosis. Actuarial freedom from structural failure and from reoperation, respectively, was 93% ± 5% and 91% ± 5% at 15 years. Echocardiographic follow-up in 24 patients with 27-mm prostheses showed a mean gradient of 5 ± 1.7 mmHg and an effective orifice area of 1.57 ± 0.3 cm2; in 16 patients with 29-mm prostheses, the mean gradient was 4.5 ± 1.9 mmHg, and the effective orifice area, 1.63 ± 0.4 cm2. During nearly 17 years of follow-up, the Mosaic bioprosthesis has shown good overall clinical and hemodynamic performance after mitral valve replacement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

Celiento¹,

Blasi²,

Martino³

et al. 2016

Texas Heart Institute Journal

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“…Pressure gradients of the Magna, the Mosaic, and the Soprano are in accord with findings of other groups. 1,[3][4][5][6]8,13,14,20,22,[25][26][27][28][29][30][31] There are preliminary in vivo hemodynamic data available regarding the Mosaic Ultra 10 and only 1 in vivo evaluation of the Epic, which was published previously by our group. 4 The in vitro data concerning hemodynamic gradients of the Epic and the Ultra correspond well with our results.…”

Section: Mean Pressure Gradientsmentioning

confidence: 99%

The Complete Supraannular Concept

et al. 2009

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Background— Complete supraannular placement of an aortic bioprosthesis is one approach to optimize the hemodynamic result of an aortic valve replacement. It is achieved with the combination of a special valve design and the supraannular sewing technique with noneverted mattress sutures. We evaluated 5 bioprostheses designed for complete supraannular placement to assess potential hemodynamic differences caused by factors (eg, valve material) other than implantation position. Methods and Results— In 336 patients (mean age, 72.0±7.1 years; 143 women), hemodynamics including mean pressure gradients, effective orifice areas, and indices and incidence of patient-prosthesis mismatch were evaluated 6 months after surgery. Annulus diameter was measured during surgery. Patients received the Carpentier Edwards Perimount Magna (Magna, n=169), the Medtronic Mosaic (Mosaic, n=46), the Mosaic Ultra (Ultra, n=17), the SJM Epic Supra (Epic, n=46), and the Sorin Soprano (Soprano, n=58). For small annulus sizes (<23 mm), the mean pressure gradients of the Magna (11.82±4.8 mm Hg) were significantly lower than the Mosaic (16.04±6.1 mm Hg) and the Ultra (22.0±4.1 mm Hg), and the Soprano (13.3±5.2 mm Hg) was hemodynamically superior to the Ultra. For medium (23 to 24 mm) and large (>24 mm) annulus sizes, the mean pressure gradients of the Magna were lower than the Epic (10.0±3.5 mm Hg versus 14.9±6.4 mm Hg; 9.9±4.0 mm Hg versus 18.6±12.7 mm Hg). Furthermore, in patients with large annulus size, the mean pressure gradients of the Soprano (11.4±3.8 mm Hg) were lower compared with the Epic (18.5±12.7 mm Hg). Severe patient-prosthesis mismatch was observed more frequently in patients with the Mosaic (12/46; 26.1%) and the Ultra (3/17; 17.6%) prostheses. Conclusions— Complete supraannular placement cannot prevent high pressure gradients or patient-prosthesis mismatch thoroughly, but the choice of a bovine prosthesis can optimize hemodynamic performance.

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“…Using porcine valve tissue combined with a flexible stent to reduce tissues stress, they have shown excellent durability with excellent hemodynamics. 69,70 Through the use of the proprietary Cinch Implant System, the Mosaic line is especially suited for minimally invasive procedures.…”

Section: Bioprosthetic Heart Valvesmentioning

confidence: 99%

Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement

et al. 2014

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Abstract-The engineering of technologies for heart valve replacement (i.e., heart valve engineering) is an exciting and evolving field. Since the first valve replacement, technology has progressed by leaps and bounds. Innovations emerge frequently and supply patients and physicians with new, increasingly efficacious and less invasive treatment options. As much as any other field in medicine the treatment of heart valve disease has experienced a renaissance in the last 10 years. Here we review the currently available technologies and future options in the surgical and transcatheter treatment of aortic valve disease. Different valves from major manufacturers are described in details with their applications.

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Hemodynamic Performance of the Medtronic Mosaic Porcine Bioprosthesis Up to Ten Years

Cited by 46 publications

References 25 publications

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

The Mosaic Mitral Valve Bioprosthesis: A Long-Term Clinical and Hemodynamic Follow-Up

The Complete Supraannular Concept

Emerging Trends in Heart Valve Engineering: Part II. Novel and Standard Technologies for Aortic Valve Replacement

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