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Hubert Francois Carton - One of the best experts on this subject based on the ideXlab platform.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic. # CLINICAL PERSPECTIVE {#article-title-37}

  • early structural valve deterioration of mitroflow aortic bioprosthesis mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background —Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR). Methods and Results —617 consecutive patients (76.1±6.3 years) underwent AVR with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6%[95%CI 88.7-94.7] for the whole cohort, 79.8%[71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Five-years overall survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the strongest correlate of overall mortality (HR=7.7; [95% CI;4.4-13.6]). Conclusions —Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm) and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery should be discussed in patients with severe SVD even though still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

Thomas Senage - One of the best experts on this subject based on the ideXlab platform.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic. # CLINICAL PERSPECTIVE {#article-title-37}

  • early structural valve deterioration of mitroflow aortic bioprosthesis mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background —Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR). Methods and Results —617 consecutive patients (76.1±6.3 years) underwent AVR with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6%[95%CI 88.7-94.7] for the whole cohort, 79.8%[71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Five-years overall survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the strongest correlate of overall mortality (HR=7.7; [95% CI;4.4-13.6]). Conclusions —Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm) and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery should be discussed in patients with severe SVD even though still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

Thierry Le Tourneau - One of the best experts on this subject based on the ideXlab platform.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic. # CLINICAL PERSPECTIVE {#article-title-37}

  • early structural valve deterioration of mitroflow aortic bioprosthesis mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background —Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR). Methods and Results —617 consecutive patients (76.1±6.3 years) underwent AVR with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6%[95%CI 88.7-94.7] for the whole cohort, 79.8%[71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Five-years overall survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the strongest correlate of overall mortality (HR=7.7; [95% CI;4.4-13.6]). Conclusions —Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm) and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery should be discussed in patients with severe SVD even though still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

Christian Perigaud - One of the best experts on this subject based on the ideXlab platform.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic. # CLINICAL PERSPECTIVE {#article-title-37}

  • early structural valve deterioration of mitroflow aortic bioprosthesis mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background —Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR). Methods and Results —617 consecutive patients (76.1±6.3 years) underwent AVR with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6%[95%CI 88.7-94.7] for the whole cohort, 79.8%[71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Five-years overall survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the strongest correlate of overall mortality (HR=7.7; [95% CI;4.4-13.6]). Conclusions —Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm) and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery should be discussed in patients with severe SVD even though still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

Antoine Mugniot - One of the best experts on this subject based on the ideXlab platform.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic. # CLINICAL PERSPECTIVE {#article-title-37}

  • early structural valve deterioration of mitroflow aortic bioprosthesis mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background —Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, the mode and the impact of SVD on outcome in a large series of Mitroflow aortic valve replacement (AVR). Methods and Results —617 consecutive patients (76.1±6.3 years) underwent AVR with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), mainly on a stenosis mode (n=36). Mean delay to SVD was only 3.8±1.4 years and five-years SVD-free survival was 91.6%[95%CI 88.7-94.7] for the whole cohort, 79.8%[71.2-89.4] and 94.0%[90.3-97.8] for 19 and 21 mm sizes, respectively. Among the 39 SVD, 13 patients (33%) had an accelerated SVD once mean gradient exceeded 30mmHg. Valve-related death was 46.2% in this SVD subgroup. Five-years overall survival was 69.6%[65.7-73.9]. In multivariable analysis SVD was the strongest correlate of overall mortality (HR=7.7; [95% CI;4.4-13.6]). Conclusions —Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm) and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent redo surgery should be discussed in patients with severe SVD even though still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesisclinical perspective mode incidence and impact on outcome in a large cohort of patients
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background— Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results— Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall survival was 69.6% (95% CI, 65.7–73.9). In multivariable analysis, SVD was the strongest correlate of overall mortality (hazard ratio=7.7; 95% CI, 4.4–13.6). Conclusions— Early SVD is frequent in Mitroflow bioprosthesis (models 12A/LX), especially for small sizes (19 and 21 mm), and reduces overall survival. An unpredictable accelerated pattern of SVD constitutes a life-threatening condition. In view of the large number of Mitroflow valves implanted worldwide, one can expect an epidemic of SVD and valve-related deaths, which represents a major public health issue, especially in the elderly. Hence, a close follow-up with yearly echocardiography after Mitroflow implantation is advisable. An urgent reoperation should be discussed in patients with severe SVD even though they are still asymptomatic.

  • early structural valve deterioration of mitroflow aortic bioprosthesis
    Circulation, 2014
    Co-Authors: Thomas Senage, Thierry Le Tourneau, Yohann Foucher, S Pattier, Caroline Cueff, Magali Michel, Antoine Mugniot, Jean-michel Serfaty, Christian Perigaud, Hubert Francois Carton
    Abstract:

    Background—Structural valve deterioration (SVD) is a major flaw of Bioprostheses. Early SVD has been suspected in the last models of Mitroflow bioprosthesis. We sought to assess the incidence, mode, and impact of SVD on outcome in a large series of Mitroflow aortic valve replacement. Methods and Results—Six hundred seventeen consecutive patients (aged 76.1±6.3 years) underwent aortic valve replacement with a Mitroflow prosthesis (models 12A/LX) between 2002 and 2007. By echocardiography, 39 patients developed early SVD (1.66% per patient-year), with stenosis as the main mode (n=36). Mean delay to SVD was only 3.8±1.4 years, and 5-year SVD-free survival was 91.6% (95% confidence interval [CI], 88.7–94.7) for the whole cohort and 79.8% (95% CI, 71.2–89.4) and 94.0% (95% CI, 90.3–97.8) for 19- and 21-mm sizes, respectively. Among the 39 patients with SVD, 13 patients (33%) had an accelerated SVD once the mean gradient exceeded 30 mm Hg. Valve-related death was 46.2% in this SVD subgroup. Five-year overall su...