On-X mitral valve replacement: a single-centre experience in 318 patients†

Murana, Giacomo; Alfonsi, Jacopo; Savini, Carlo; Mariani, Carlo; Coppola, Giuditta; Coco, Valeria Lo; Pacini, Davide; Bartolomeo, Roberto Di

doi:10.1093/icvts/ivy184

Cited by 10 publications

(14 citation statements)

References 18 publications

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“…There is no consensus regarding the predictors of valve surgery mortality, and their identification varies widely according to the population studied and study method. Age, for example, has already been identified as an important predictor numerous times [ 4 , 7 , 8 , 12 - 14 , 18 - 21 ] , in agreement with what was found here. On the other hand, a number of other studies did not show its relationship with worse outcome [ 11 ] or even identified the inverse relationship [ 22 ] .…”

Section: Discussionsupporting

confidence: 92%

“…The hospital mortality found in this study (6.7%) was similar to that found in most other studies on valve replacement [ 10 , 11 , 14 ] , being within the normal range (4 to 7%) [ 5 ] . The causes of death vary among studies.…”

Section: Discussionsupporting

confidence: 90%

“…On the other hand, Eguchi et al [ 9 ] observed that all deaths were related to infection. Most studies show infection, cardiac causes, and neurological events (which are the main causes in this study) as frequent causes of death in valvular procedures [ 9 , 11 , 12 , 14 , 19 , 20 ] .…”

Section: Discussionmentioning

confidence: 74%

“…Studies in high-income countries have valve degeneration secondary to aging or ischemic valve injury as the main etiology leading to replacement. Hence, they can show a slightly higher average age [ 10 , 14 ] . Studies carried out on samples with rheumatic being the most prevalent etiology show lower averages, as well as that found in the present study [ 16 , 17 ] .…”

Section: Discussionmentioning

confidence: 99%

“…Among the preoperative comorbidities, coronary artery disease is the most frequently identified as a predictor of mortality. Numerous studies have already shown its association with worse outcome [ 12 - 14 , 19 ] . Other comorbidities, such as stroke, hypertension, chronic obstructive pulmonary disease, and chronic renal failures have also been identified [ 13 , 24 ] .…”

Section: Discussionmentioning

confidence: 99%

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Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Moreira

Barletta

Baucia

2021

Braz J Cardiovasc Surg

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Introduction We aimed to identify predictors of morbidity and mortality in patients undergoing isolated mitral valve replacement. Methods This is a retrospective cohort study with 164 patients who underwent isolated mitral valve replacement at a referral hospital for cardiovascular diseases, which were performed from January 2011 to December 2016. Data were obtained from medical records, including preoperative, intraoperative, and postoperative information. Statistical analysis was performed to calculate odds ratio (OR), unpaired Student's t -test, and binary logistic regression. P -values < 0.05 were considered significant. Results A total of 69.5% (n=114) of the patients had a diagnosis of rheumatic disease prior to surgery. Mortality rate was 6.7% (n=11). The most observed complication was the occurrence of postoperative arrhythmias (19.5%). On average, patients remained 5.34 days in the intensive care unit. There was a statistically significant enhanced risk of death among patients with previous diagnosis of endocarditis (OR 5.22, 95% confidence interval [CI] 1,368-19,915; P =0.008), reduced ejection fraction (EF) (< 50%) (OR 9.46, 95% CI 2,61-34,35; P <0.001), and mitral regurgitation (MR) (OR 7.7, 95% CI 1.576-37.545; P =0.004). Patients who died were older than those who survived surgery ( P <0.001) and had lower preoperative serum hemoglobin levels ( P =0.018). Logistic regression showed age and reduced EF at preoperative evaluation as predictors of death. Conclusion Older age, reduced serum hemoglobin levels, preoperative diagnosis of endocarditis, reduced EF, and MR were associated with postoperative mortality. Age and reduced EF were predictors of death.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Moreira

Barletta

Baucia

2021

Braz J Cardiovasc Surg

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Carbon in Biomedical Engineering

Kawalec

2021

Encyclopedia of Materials: Technical Ceramics and Glasses

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Long-term outcomes with the On-X bileaflet mitral valve: clinical events up to 17 years in 661 patients

Reyes

Muñoz

Monguió

et al. 2022

European Journal of Cardio-Thoracic Surgery

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OBJECTIVES This study reports long-term clinical outcomes—up to 17 years—among patients undergoing mitral valve replacement with the On-X bileaflet mechanical valve. Prior data regarding long-term outcomes with the On-X mitral valve have been limited. METHODS This retrospective observational study included all patients who underwent mitral valve replacement with the On-X (Standard or Conform-X) valve at 2 major Spanish cardiac surgery centres between 2001 and 2018. The primary study end point was freedom from death. The secondary study end points included surgical mortality and freedom from any valve-related events. Data were obtained from an institutional database, medical records review, direct telephone interviews or the Spanish population registry. Statistical and Kaplan–Meier analyses were performed. RESULTS A total of 661 patients (mean age 63.1 ± 10.9 years, 63% female) were followed for a mean of 5.6 years (range, 0–17.4 years). Survival at 5, 10 and 15 years was 85%, 71% and 63%, respectively. Surgical mortality was 7.3% (48/661). The linearized rate of global mortality was 1.3% patient-year. Freedom from reoperation was 97%, 95% and 92% at 5, 10 and 15 years, respectively; freedom from anticoagulation-related events was 94%, 89% and 89%, respectively. Multivariable analysis showed that mortality increased with total length of stay, age, smoking history, severe pulmonary hypertension and a permanent pacemaker. Patients who received the On-X 25 -mm valve had decreased long-term survival relative to patients who received other On-X valve sizes, possibly due to underlying risk factors. CONCLUSIONS Patients in this study showed good long-term survival and freedom from valve-related events.

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On-X mitral valve replacement: a single-centre experience in 318 patients†

Cited by 10 publications

References 18 publications

Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Morbidity and Mortality in Patients Undergoing Mitral Valve Replacement at a Cardiovascular Surgery Referral Service: a Retrospective Analysis

Carbon in Biomedical Engineering

Long-term outcomes with the On-X bileaflet mitral valve: clinical events up to 17 years in 661 patients

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