EPIC Valve

BACKGROUND/AIM: To evaluate three mitral bioprostheses (of comparable measured internal diameters) under controlled, stable, hemodynamic and surgical conditions by bench, echocardiographic, computerized tomography and autopsy comparisons pre- and postvalve implantation. METHODS: Fifteen similar-sized Yorkshire pigs underwent preprocedural computerized tomography anatomic screening. Of these, 12 had consistent anatomic features and underwent implantation of a mitral bioprosthesis via thoracotomy on cardiopulmonary bypass (CPB)...

Much has changed since the introduction of surgical valve repair in the 1950s, from the introduction bioprosthetic valves to percutaneous approaches to valve repair. Yet, despite substantial advancements in bioprosthetic valve technology, there has been a lack of direct, independent comparison between bioprosthetic mitral valve devices, accompanied by a marked heterogeneity in approaches to the sizing and selection thereof. Wang et al. have hence endeavored to evaluate, head-to-head, the technical successes and biomechanical outcomes associated with three different bioprosthetic mitral valves (Epic; Abbott; Mosaic; Medtronic; Mitris Resilia; Edwards Lifesciences) in a porcine model, under standardized hemodynamic and anatomical conditions...

Background - Elevated Lipoprotein(a) (Lp[a]) levels are associated with coronary artery disease (CAD), ischemic stroke (IS) and calcific aortic valve stenosis (CAVS). Studies investigating the association between Lp(a) levels and these diseases in women have yielded inconsistent results. Methods - To investigate the association of Lp(a) with sex-specific cardiovascular outcomes, we determined the association between genetically-predicted Lp(a) levels (using 27 single nucleotide polymorphisms (SNPs) at the LPA locus) and hepatic LPA expression (using 80 SNPs at the LPA locus associated with LPA mRNA expression in liver samples from the Genotype-Tissue Expression dataset) on CAD, IS and CAVS using individual participant data from the UK Biobank: 408,403 participants of European ancestry (37,102, 4283 and 2574 with prevalent CAD, IS and CAVS, respectively)...

An 82-year-old female patient with severe mitral regurgitation was referred for evaluation of percutaneous mitral valve repair. Transoesophageal echocardiography revealed a left-atrial septal pouch (LASP) with an echogenic structure. Following the heart-team decision, interventional therapy was therefore discarded. During surgery, a thrombus in the LASP was found and carefully resected. Afterward, conventional valve replacement with a biological 31-mm SJM-EPIC prosthesis (Abbott Structural Heart Devices, Santa Clara, CA) was performed...

BACKGROUND: Patient-prosthesis mismatch (PPM) has been identified as a risk factor for mortality and reoperation in patients undergoing surgical aortic valve replacement (SAVR). We present a retrospective analysis of risk factors for PPM and the effects of PPM on early postoperative outcomes after SAVR. METHODS: Chart review was conducted for patients (N = 3003) undergoing SAVR. PPM was calculated from valve reference orifice areas and patient body surface area...

BACKGROUND: To evaluate the durability of a third-generation porcine bioprosthesis (Epic® valve) in the mitral position, according to patients' age at surgery. METHODS: A total of 482 mitral valve replacements (MVR) using the Epic® valve at a single center were included (2009-2018). Perioperative and early postoperative data were prospectively collected. A systematic follow-up was performed (99% complete, 1,609.5 patient/years, average: 3.8 ± 2.5 years). Standardized definitions of valve-related events were adopted...

To assess the early hemodynamics after mitral valve replacement (MVR) using the St Jude Medical (SJM) Epic bioprosthesis. MVR was performed using the SJM Epic bioprosthesis in 35 patients from June 2018 to April 2020; three patients were excluded because the postoperative transthoracic echocardiography (TTE) data were unavailable. Data from postoperative TTE at 1 week and 3 months after the procedure were reviewed. The mean mitral pressure gradient (mMPG) was calculated using a continuous wave Doppler method...

No abstract text is available yet for this article.

The writer Bertolt Brecht (1898-1956) is known for his poems, dramas and the "epic or dialectical theater" he founded. He was retrospectively postulated to have had rheumatic fever because of heart problems and neuromuscular symptoms in his youth. Based on current rheumatological knowledge, it cannot be deduced with certainty from the available documents that Brecht had rheumatic fever. At most, a very unusual manifestation of rheumatic fever can be suspected with atypical rheumatic chorea and a very atypical course of rheumatic carditis...

No abstract text is available yet for this article.

BACKGROUND: The aim of this study was to evaluate the results after stented porcine xenograft implantation (Epic, SJM, St Paul, MN) with Linx anticalcification treatment in elderly patients at our high-volume tertiary care center. METHODS: A total of 3825 patients undergoing aortic (AVR = 2441), mitral (MVR = 892), or double valve (DVR = 492) replacement between 11/2001 and 12/2017 with Epic xenografts were evaluated. Outcomes were assessed by reviewing the prospectively acquired hospital database results, and regular annual follow-up information was acquired from questionnaires or telephone interviews...

BACKGROUND: The Evaluation of pimobendan in dogs with cardiomegaly caused by preclinical myxomatous mitral valve disease (EPIC) study monitored dogs with myxomatous mitral valve disease (MMVD) as they developed congestive heart failure (CHF). OBJECTIVES: To describe the changes in clinical and radiographic variables occurring as dogs with MMVD and cardiomegaly develop CHF, compared to similar dogs that do not develop CHF. ANIMALS: One hundred and thirty-five, and 73 dogs that did or did not develop CHF, respectively...

This report highlights the need for close surveillance of bioprosthetic valves. Unaccountable degeneration of bioprosthetic valves can develop early after implantation and usually requires replacing the failed valve with a mechanical prosthesis.

AIMS: We assessed the impact of implant depth on hydrodynamic function following valve-in-valve (VIV) intervention using the ALLEGRA (New Valve Technology, Hechingen, Germany) transcatheter heart valve (THV) in three different surgical valve designs. METHODS AND RESULTS: Multiple implantation depths (+2mm, -2mm and -6mm) were tested using a 23mm ALLEGRA THV for VIV intervention in 19mm, 21mm, 23mm, and 25mm Epic, Mitroflow and Magna Ease bioprosthetic valves. Multimodality imaging and hydrodynamic evaluation was performed at each implantation depth...

Background Apolipoprotein B/apolipoprotein A-I (apoB/apoA-I) ratio and lipoprotein(a) (Lp[a]) are associated with aortic valve stenosis (AVS) disease progression. Clinical characteristics such as age, sex, and presence of concomitant coronary artery disease may strongly modify these associations; however, these effects have not been well defined in longitudinal studies. We set out to assess these associations between apoB/apoA-I ratio, Lp(a), and AVS incidence in a large population study. Methods and Results We analyzed data from 17 745 participants (mean age, 59...

Importance: Genetic variants at the LPA locus are associated with both calcific aortic valve stenosis (CAVS) and coronary artery disease (CAD). Whether these variants are associated with CAVS in patients with CAD vs those without CAD is unknown. Objective: To study the associations of LPA variants with CAVS in a cohort of patients undergoing heart surgery and LPA with CAVS in patients with CAD vs those without CAD and to determine whether first-degree relatives of patients with CAVS and high lipoprotein(a) (Lp[a]) levels showed evidence of aortic valve microcalcification...

INTRODUCTION: The advanced design techniques used in modern prosthetic heart valve (PHV) development require accurate replication of the entire cardiac cycle. While cardiac pulse duplicator (CPD) design has a direct impact on the PHV test data generated, no clear guidelines exist to evaluate the CPD's performance. In response to this, we present a method to quantitatively assess CPD performance. MATERIALS AND METHODS: A method to establish the fidelity of CPDs was formulated based on the pressure/time relationship and the error related to this relationship's target...

BACKGROUND: The aim of this single-center study was to report the midterm clinical outcomes and hemodynamic performance of the St Jude Medical Epic porcine bioprosthesis, a tricomposite glutaraldehyde-preserved porcine bioprosthesis, in mitral position. Methods and Results: Between January 2011 and March 2017, 117 patients (62 men, 55 women; mean age, 66.7±12.8 years) who underwent mitral valve replacement (MVR) with the Epic valve were retrospectively analyzed for early and mid-term morbidity and mortality...

BACKGROUND: Calcific aortic valve stenosis (CAVS) is the most prevalent heart valve disease in Western societies. The American Heart Association 2020 Strategic Impact Goals introduced the concept of ideal cardiovascular health, which includes seven cardiovascular health metrics, namely body mass index, a healthy diet, physical activity, smoking status, blood pressure, fasting plasma glucose and cholesterol levels. Several prospective studies have shown that compared to people who meet few of the criteria of ideal cardiovascular health, those with ideal cardiovascular health have an 80-90% lower risk of cardiovascular events...

AIMS: The 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 BP, the clinical outcomes have been suboptimal due to high post-procedural gradients. We aimed to examine the effect of size and position of the self-expanding transcatheter heart valve (THV) CoreValve on the haemodynamics of ViV within small BP. METHODS AND RESULTS: Sizes 23 and 26 mm of the CoreValve were implanted in sizes 19 and 21 mm of three BP models: Trifecta, Mitroflow and Epic Supra...