Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598964
e-Poster Presentations
Tuesday, February 14th, 2017
DGTHG: e-Poster - Acquired Heart Valve Disease
Georg Thieme Verlag KG Stuttgart · New York

Outcome after Mitral Valve Replacement (MVR) Using Biological versus Mechanical Valves

A. Cetinkaya
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
M. Richter
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
M. Schönburg
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
W. Skwara
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
Z. Szalay
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
S. Hein
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
N. Thaqi
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
,
T. Walther
1   Kerckhoff Klinik Bad Nauheim, Cardiac Surgery, Bad Nauheim, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

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Objectives: Aim of this study was to compare the outcomes (30 days) after biological (B) versus mechanical (M) mitral valve replacement (MVR) in case mitral valve repair was not feasible.

Methods: From 2005 until 2014, a total of 1,121 patients received mitral valve surgery at out institution. Of these patients, 275 patients received MVR, 218 received B-MVR, and 57 patients received M-MVR. Minimally invasive surgical access was used in 49.1% of patients, thereof in 45.2% (B) versus 63.8% (M); p = 0.012. Combined tricuspid valve repair (TVR) was necessary in 19.0%, thereof in 19.4% (B) versus 17.2% (M); p = 0.851, ablation for atrial fibrillation in 27.7%, thereof in 26.7% (B) versus 31.6% (M); p = 0.507 and LAA-closure in 26.9%, thereof in 27.2% (B) versus 25.9% (M); p = 1.00.

Underlying mitral valve pathology was degenerative in 95.6%. Amongst those 12.7% with acute endocarditis, 28.7% with MV stenosis and 46.2% restrictive leaflets.

Results: Mean patient age was 70.0 years (B) versus 56.0 years (M); p < 0.001 and 50.2% (B) versus 43.1% (M) were female; p = 0.376. NYHA III–IV occurred in 82.5% (B) versus 82.7% (M); p = 0.967 and preoperative emergency/urgent indication for operation was in 16.8% (B) versus in 17.1% (M); p = n.s.; the reason for operation was acute endocarditis in 12.0% (B) versus in 15.5% (M); p = 0.507.

A simultaneous tricuspid valve repair had to be performed in 19.4% (B) versus 17.2% (M); p = 0.851 and cryoablation was done in 26.8% (B) versus in 31.6% (M); p = 0.507.

Median MV prosthesis size was 31.0 ±1.9 (B) versus 31.0 ±1.7 (M); p = n.s.

Mean red blood cell transfusion was 2.6 ± 7.6 (B) versus 7.2 ± 25.1 (M); p = 0.591. Re-thoracotomy rate was 8.8% (B) versus 20.7% (M); p = 0.018, wound infection occurred in 2.3% (B) versus in 1.7% (M), p = n.s. and 30-day mortality was 7.4% (B) vs. 10.3% (M); p = 0.427. Median LOS time was 11 days in (B) versus 14 days in (M); p = 0.008.

Conclusion: Mitral valve replacement in case MV repair is not feasible leads to acceptable results. Differences between mechanical and biological prostheses are mostly due to the underlying conditions of the patients. Longer term outcomes will be evaluated.