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- Title
Midterm results after St Jude Medical Epic porcine xenograft for aortic, mitral, and double valve replacement.
- Authors
Jawad, Khalil; Lehmann, Sven; Koziarz, Alex; Dieterlen, Maja; Feder, Stefan; Misfeld, Martin; Garbade, Jens; Rao, Vivek; Borger, Michael
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>For patients undergoing AVR, MVR, DVR, age at surgery were 76.4 ± 6, 71.2 ± 9, 72.9 ± 8 years; active endocarditis was an indication for valve surgery in 4.5%, 20.7%, 19.7%; and the predicted median (interquartile range [IQR]) mortality risk (EuroSCORE II) was 5.2% (3.1%-9.4%), 7.5% (3.9%-16.2%), 9.9% (6.0%-19.6%), respectively. Median follow-up was 3.04 (IQR: 0.18-5.21). Thirty-day survival was 91.2% ± 0.6%, 87.6% ± 0.1.1%, 84.7% ± 1.6%; and 10-year survival was 56.7% ± 1.0%, 59.4% ± 2.5%, 50.45% ± 3.1%, respectively. Patients who underwent MVR versus AVR were at significant increased risk for reoperation for endocarditis (adjusted odds ratio; 2.2, 95% confidence interval; 1.29-3.7; P = .003). There was no significant difference in all-cause mortality at midterm in AVR vs MVR in the matched cohort (P = .85).<bold>Conclusions: </bold>Implantation of the Epic stented porcine xenograft is associated with acceptable survival and freedom from valve-related complications or reoperation due to structural valve disease at midterm follow-up.
- Subjects
SAINT Paul (Minn.); OLDER patients; VALVES; HEART valve prosthesis implantation; TELEPHONE interviewing; ODDS ratio; TERTIARY care; AORTIC valve surgery; MITRAL valve surgery; RELATIVE medical risk; XENOGRAFTS; TIME; TREATMENT effectiveness; PROSTHETIC heart valves
- Publication
Journal of Cardiac Surgery, 2020, Vol 35, Issue 8, p1769
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/jocs.14554