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Anne-Sophie Zenses, Morgane A Evin, Viktória Stanová, Marie-Annick Clavel, Paul Barragan, Josep Rodés-Cabau, Jean-François Obadia, Philippe Pibarot, Régis Rieu
AIMS: Valve-in-Valve (ViV) procedure has become a valuable alternative for the treatment of failed surgical bioprostheses (BP) in high risk patients. However, in small BPs, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed at examining the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the hemodynamics of ViV within small BPs. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of 3 BP models: Trifecta, Mitroflow and Epic Supra...
March 13, 2018: EuroIntervention
Giovanni A Chiariello, Emmanuel Villa, Antonio Messina, Margherita Dalla Tomba, Marco Cirillo, Federico Brunelli, Zean Mhagna, Giovanni Troise
No abstract text is available yet for this article.
February 27, 2018: Interactive Cardiovascular and Thoracic Surgery
Giovanni A Chiariello, Emmanuel Villa, Antonio Messina, Margherita Dalla Tomba, Marco Cirillo, Federico Brunelli, Zean Mhagna, Giovanni Troise
Because of its favourable haemodynamic characteristics and easy implantability, Mitroflow aortic valve bioprosthesis has been the valve of choice for many surgeons in patients with small aortic annulus. Disappointingly, early structural valve deterioration and high transvalvular gradients have been reported mostly in older patients with small prostheses. Reimplanting a new stented prosthesis sutured in a narrow and damaged annulus is technically challenging and demanding mainly in high-risk patients. Valve-in-valve transcatheter aortic valve implantation has been proposed as a viable option; however, it presents significant limitations because of residual high transprosthetic pressure gradients and risk of coronary occlusion...
January 11, 2018: Interactive Cardiovascular and Thoracic Surgery
Alexander Sedaghat, Jan-Malte Sinning, Nikos Werner, Georg Nickenig, Lenard Conradi, Stefan Toggweiler, Ulrich Schäfer
AIMS: The aim of this study was to assess the in-vitro hydrodynamic performance of a novel self-expanding transcatheter heart valve prosthesis (THV), the NVT AllegraTM, in 5 different surgical bioprostheses. In addition, we present a series of valve-in-valve implantations in the clinical setting using the 23mm AllegraTM prosthesis. METHODS AND RESULTS: The 23mm NVT AllegraTM was implanted in 5 different surgical bioprostheses of 23mm nominal size, namely the Edwards Perimount, the Sorin MitroFlow, the St...
December 19, 2017: EuroIntervention
Marco Gennari, Gianluca Polvani, Mara Rubino, Francesco Arlati, Andrea Annoni, Marco Agrifoglio
Bioprosthesis are commonly used in the elderly population. Structural valve deterioration affects the long-term durability. We report an early deterioration of a Mitroflow valve caused by ring deformation and prosthetic leaflet rupture. The 69-years-old patient underwent successful redo surgery with excision of the bioprosthesis and placement of a mechanical valve.
November 29, 2017: General Thoracic and Cardiovascular Surgery
Carlo Bassano, Valentina Gislao, Emanuele Bovio, Sonia Melino, Ilaria Tropea, Guglielmo Saitto, Marta Pugliese, Dionisio F Colella, Antonio Scafuri, Giovanni Ruvolo
BACKGROUND: An alarming rate of early failure has been recently reported for the LivaNova (previously Sorin) Mitroflow (LivaNova, London, UK) bioprosthesis. Here, we aimed at verifying if this possible underperformance is confirmed in a large, single-center experience and identifying the risk factors associated with early deterioration. METHODS: In all, 459 Mitroflow valves have been implanted from July 2009 to December 2013 (patients' mean age 73 years; 204 women)...
November 1, 2017: Annals of Thoracic Surgery
Issa Farah Issa, Steen Hvitfeldt Poulsen, Farhad Waziri, Christian Torp Pedersen, Per Hostrup Nielsen, Lars Riber, Jordi S Dahl, Peter Søgaard, Martin Agge Nørgaard, Jacob Eifer Møller
OBJECTIVES: Concern has been raised regarding the long-term durability of the Mitroflow biological heart valve prosthesis. Our aim was to assess the incidence of structural valve degeneration (SVD) for the Mitroflow bioprosthesis in a nationwide study in Denmark including all patients alive in Denmark who had received a Mitroflow aortic bioprosthesis since 2000. METHODS: Patients alive in Denmark with a Mitroflow bioprosthesis implanted since January 2000 were invited to participate in a nationwide cross-sectional study with a predefined definition of SVD...
September 28, 2017: European Journal of Cardio-thoracic Surgery
Daniel Hernandez-Vaquero, Rocio Diaz, Isaac Pascual, Jose Rozado, Jesus M De la Hera, Victor Leon, Pablo Avanzas, Maria Martín, Daniel García-Iglesias, David Calvo, Jacobo Silva, César Moris
BACKGROUND: Some important studies have shown that patient-prosthesis mismatch is a frequent occurrence after surgical aortic valve replacement that impairs survival. The Trifecta valve (St. Jude Medical Inc, St. Paul, MN) has special architecture designed to achieve the best hemodynamic profile. The aim of this study was to determine the prevalence of mismatch when using this prosthesis. METHODS: This study included 1,302 patients at 3 months postoperatively, 339 patients with a Trifecta prosthesis and 963 patients (the control group) with a Mitroflow aortic valve (Sorin Group Inc, Mitroflow Division, Vancouver, Canada)...
January 2018: Annals of Thoracic Surgery
Marianna Adamo, Claudia Fiorina, Salvatore Curello, Giuliano Chizzola, Elena Pezzotti, Emanuele Gavazzi, Luca Branca, Ermanna Chiari, Filippo Quinzani, Michele Rinaldi, Marco Metra, Federica Ettori
AIMS: The aim of this study was to report clinical outcomes of self-expanding transcatheter aortic valve implantation (TAVI) for failed small Mitroflow (MF) bioprostheses. METHODS AND RESULTS: Between January 2013 and July 2016, 15 symptomatic patients (NYHA Class ≥III) with degenerated small MF (≤23 mm) underwent CoreValve (CV) or Evolut R (EvR) implantation due to high/prohibitive risk for surgical redo. The MF size was 19 or 21 mm (off-label in Europe) in eight patients...
September 10, 2017: EuroIntervention
Fabio Ius, Julia Schulz, Mazen Roumieh, Felix Fleissner, Issam Ismail, Igor Tudorache, Gregor Warnecke, Andreas Martens, Malakh Shrestha, Dietmar Boethig, Axel Haverich, Serghei Cebotari
OBJECTIVES: The Mitroflow aortic pericardial bioprosthesis was widely employed in the past. However, some authors have recently reported early structural valve deterioration (SVD) of the Mitroflow LA/LXA model. Thus, we reviewed our experience with the Mitroflow bioprosthesis and studied the risk factors for SVD and mortality. METHODS: Records of patients who underwent aortic valve replacement with a Mitroflow bioprosthesis between November 2005 and January 2015 were retrospectively evaluated with Kaplan-Meier, Cox-regression and multistate analysis...
August 1, 2017: European Journal of Cardio-thoracic Surgery
Adnan K Chhatriwalla, Keith B Allen, John T Saxon, David J Cohen, Sanjeev Aggarwal, Anthony J Hart, Suzanne J Baron, Danny Dvir, A Michael Borkon
BACKGROUND: Valve-in-valve (VIV) transcatheter aortic valve replacement (TAVR) may be less effective in small surgical valves because of patient/prosthesis mismatch. Bioprosthetic valve fracture (BVF) using a high-pressure balloon can be performed to facilitate VIV TAVR. METHODS AND RESULTS: We report data from 20 consecutive clinical cases in which BVF was successfully performed before or after VIV TAVR by inflation of a high-pressure balloon positioned across the valve ring during rapid ventricular pacing...
July 2017: Circulation. Cardiovascular Interventions
Jens Erik Nielsen-Kudsk, Asger Andersen, Christian Juhl Therkelsen, Evald Høj Christensen, Kaare Troels Jensen, Lars Romer Krusell, Mariann Tang, Kim Allan Terp, Kaj-Erik Klaaborg, Jacob Raben Greisen, Bjarne Linde Nørgaard, Henning Rud Andersen
AIMS: Transcatheter valve-in-valve (VIV) implantation is usually discouraged in small surgical tissue valves. We report our first ten cases of fracturing small dysfunctional Mitroflow bioprostheses by high-pressure balloon dilatation to increase the internal diameter of the surgical valve before VIV (BF-VIV). METHODS AND RESULTS: BF-VIV was performed in 10 patients (mean age 84±4 years) with failing Mitroflow valves size 19 mm (n=3, threshold of fracture 15 atm) and 21 mm (n=7, threshold of fracture 13 atm)...
September 10, 2017: EuroIntervention
Keith B Allen, Adnan K Chhatriwalla, David J Cohen, John T Saxon, Sanjeev Aggarwal, Anthony Hart, Suzanne Baron, J Russell Davis, Alex F Pak, Danny Dvir, A Michael Borkon
BACKGROUND: Valve-in-valve transcatheter aortic valve replacement is less effective in small surgical bioprostheses. We evaluated the feasibility of bioprosthetic valve fracture with a high-pressure balloon to facilitate valve-in-valve transcatheter aortic valve replacement. METHODS: In vitro bench testing on aortic tissue valves was performed on 19-mm and 21-mm Mitroflow (Sorin, Milan, Italy), Magna and Magna Ease (Edwards Lifesciences, Irvine, CA), Trifecta and Biocor Epic (St...
November 2017: Annals of Thoracic Surgery
Theodor Fischlein, Steffen Pfeiffer, Vincenzo Bagnardi, Giuseppe Santarpino
INTRODUCTION: The aim of this study was to evaluate durability of Mitroflow and patterns of use compared with other aortic valves through a systematic review of the literature. EVIDENCE ACQUISITION: A total of 52 papers that included 33,630 patients met eligibility requirements that allowed summary statistical information to be determined regarding structural valve degeneration risk. EVIDENCE SYNTHESIS: Mitroflow has been disporportionately implanted in patients to be at higher risk for structural valve degeneration...
December 2017: Journal of Cardiovascular Surgery
Stefano Salizzoni, Federico Conrotto, Mauro Rinaldi, Gian Paolo Ussia, Gaetana Ferraro, Mauro Giorgi, Maurizio D'Amico
A small-sized bioprosthesis can limit transcatheter valve-in-valve (V-in-V) implantations. The case is reported of a 91-year-old woman who had successfully undergone a V-in-V procedure with a 26 mm CoreValve in a previously implanted Mitroflow 19 mm valve. At the five-year follow up the prosthesis showed good echocardiographic function and the patient was alive and free from major symptoms. The patient died three months after the follow up examination at the age of 96 years. This case demonstrates the feasibility, with acceptable longterm functioning, of a V-in-V procedure involving a small bioprosthesis...
January 2017: Journal of Heart Valve Disease
Thierry Carrel
No abstract text is available yet for this article.
August 1, 2017: European Journal of Cardio-thoracic Surgery
Giordano Tasca, Gianfranco Beniamino Fiore, Paola Redaelli, Claudia Romagnoni, Alberto Redaelli, Amando Gamba, Carlo Antona, Riccardo Vismara
Hydrodynamic performance of stented bioprostheses is far below that of the native valve. One of the reasons is that the internal diameter of the prosthesis is usually smaller than that of the native valve. However, other valve characteristics are also important in generating the pressure drop. We aimed to assess, in an ex vivo pulsatile mock loop, the hydrodynamic behavior of two bioprostheses, Trifecta and Mitroflow, to ascertain which geometric terms are limiting factors in hydrodynamic performance. At stroke volumes between 30 and 60 ml, Trifecta showed lower pressure drop, energy dissipation and valve resistance, and greater effective orifice area...
May 4, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Rocío Díaz, Daniel Hernández-Vaquero, Jacobo Silva, Isaac Pascual, Jesús M de la Hera, Víctor León, María Martín, Vicente Barriales, Santiago Colunga, Raquel Del Valle, César Morís
INTRODUCTION AND OBJECTIVES: The Mitroflow aortic prosthesis is a bovine pericardial bioprosthesis specially designed to increase the valve area in relation to its size. There is controversy regarding the pattern of structural valve deterioration (SVD). Our aim was to determine the cumulative incidence of SVD, risk factors influencing its occurrence, and its impact on mortality. METHODS: A total of 1028 patients were clinically and echocardiographically followed up...
December 2017: Revista Española de Cardiología
Liesbeth Lootens, Jonas Verbeke, Thomas Martens, Tine Philipsen, Frank Caes, Yves Van Belleghem, Guido Van Nooten, Katrien François, Dirk De Bacquer, Thierry Bove
OBJECTIVES: Concerns have been raised about the durability of the first-generation Mitroflow aortic bioprosthesis (model 12 A-LX) due to the lack of anticalcification treatment. This study reflects a 10-year experience with this prosthesis for aortic valve replacement. METHODS: From June 2003 to May 2012, the Mitroflow prosthesis was used for aortic valve replacement in 510 patients, of whom only 467 with complete clinical follow-up were included for analysis. Study end-points were survival and incidence of structural valve degeneration (SVD)...
August 1, 2017: European Journal of Cardio-thoracic Surgery
(no author information available yet)
No abstract text is available yet for this article.
April 1, 2017: European Journal of Cardio-thoracic Surgery
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