Mitroflow pericardial bioprosthesis experience in aortic valve replacement>= 60 years of age

Background. The Mitroflow pericardial bioprosthesis (model 11), a second-ge neration pericardial prosthesis, has clinical performance assessment to 10 years. The authors previously recommended the prosthesis for aortic valve r eplacement in patients 70 years or older. The purpose of the current assess ment is to report on performance in patients 60 years or older undergoing a ortic valve replacement. Methods. This bioprosthesis was implanted in 161 patients (mean age, 69.5 /- 6.3 years; range, 60 to 94 years) with aortic valve replacement from 198 2 to 1992. There were 84 patients 60 to 69 years (mean, 64.5 +/- 3.1 years) and 77 patients 70 years or older (mean, 74.8 +/- 4.3 years). Of the total population, concomitant procedures were performed in 63 patients (39.1%); of these, coronary artery bypass grafting was performed in 39 (24.2%). Results. The early mortality was 4.8% (4 patients) for the 60 to 69-year ag e group and 10.4% (8) for those 70 years or older (not significant). The la te mortality was 4.4%/patient-year (27) for those 60 to 69 years and 6.9%/p atient-year (35) for those 70 years or older (not significant). The patient survival for those 60 to 69 years was 58.0% +/- 6.3% and for those 70 year s or older, 45.3% +/- 5.9% at 10 years (p < 0.05). The valve-related mortal ity for those 60 to 69 years was 0.82%/patient-year (5) and for those 70 ye ars or older, 1.58%/patient-year (8) (not significant). The reoperation rat e for those 60 to 69 years was 3.29%/patient-year (20) and for those 70 yea rs or older, 1.0%/patient-year (5) (p < 0.05). The structural valve deterio ration rate for those 60 to 69 years was 3.13%/patient-year (19) and for th ose 70 years or older, 1.2%/patient-year (6) (p < 0.05). Conclusions. The Mitroflow pericardial bioprosthesis remains recommended fo r aortic valve replacement in patients 70 years and older. (C) 1998 by The Society of Thoracic Surgeons.