Thorac Cardiovasc Surg 2017; 65(S 01): S1-S110
DOI: 10.1055/s-0037-1598675
Oral Presentations
Sunday, February 12, 2017
DGTHG: Acquired Heart Valve Disease: Mitral Valve
Georg Thieme Verlag KG Stuttgart · New York

Biologic Mitral Valve Replacement in Patients Younger Than 60 Years: Initial Outcomes and Long-Term Follow-up

M. Wilbring
1   Universitätsklinikum Halle (Saale), Universitätsklinik und Poliklinik für Herzchirurgie, Halle, Germany
,
E. Voigt
2   Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
K. Alexiou
2   Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
U. Kappert
2   Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
S.M. Tugtekin
2   Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
,
K. Matschke
2   Cardiac Surgery, University Heart Center Dresden, Dresden, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
03 February 2017 (online)

   All articles of this category

Objectives: Particularly for younger patients, mechanical substitutes are recommended if mitral valve replacement (MVR) becomes necessary. Nonetheless, some younger adults want a biologic substitute for several reasons. The present study reports long-term outcomes after biologic MVR younger 60 years.

Patients and methods: A total of 1,350 mitral valve replacements were analyzed. Endocarditis or concomitant CABG was ruled out. Out of these, 314 patients (23.2%) were younger 60 years and from these, 65 patients (20.7%) received biologic valve replacement. Mean patient's age was 50.2 ± 9.3 years. Median follow-up time of the hospital survivors was 1216 days, equaling 180 patient years.

Results: Mean logistic EuroSCORE was 9 ± 13% with a high incidence of relevant co-morbidities, as pulmonary hypertension 40.0%, diabetes 15.4% and chronic kidney disease 30.8%. Type of surgery consisted of isolated MVR (53.6%), MVR and aortic valve replacement (17.9%), MVR and tricuspid valve surgery (25.0%) and triple valve procedures (3.6%). Three patients died during their primary hospital stay (4.6%). 1-, 5-, and 10-year survival was 75.0, 66.3, and 55.2%, respectively. 1-, 5-, and 10-year survival free from reoperation was 75.0, 54.0, and 39.4%, respectively. A total of 21 patients (32.3%) needed reoperation during first ten postoperative years. Reasons for reoperation were valvular degeneration (53.3%) and prosthetic valve endocarditis (46.7%).

Conclusion: The decision for biologic MVR was more likely made in severely diseased patients. Nonetheless, the long-term results, particularly with regard on reoperations remain sobering. The decision for a biologic substitute in younger patients should be properly argued.