Early experience with the mosaic bioprosthesis: A new generation porcine valve

Background. The Mosaic bioprosthesis is a new generation stented porcine va lve. Methods. Between May 1995 and April 1998, this valve was implanted in the a ortic position in 98 patients (70 men; mean age, 69.2 years [34.2 to 83.6 y ears]). Preoperatively 35 patients were in New York Heart Association funct ional class 3 or 4. Fifty-nine patients underwent concomitant procedures. T he mean duration at follow-up in January 1999 was 23.7 +/- 10.2 months (0.3 to 39.4 months) and totaled 193 patient-years. All but one survivor was in New York Heart Association class 1 or 2. Results. Early complications included 1 death, 3 reoperations for bleeding, greater than mild regurgitation (paravalvar) in 1 patient and thromboembol ism in 4 patients. Late complications included four deaths, study-valve end ocarditis in 3 patients, more than mild regurgitation or hemolysis in 2, an d thromboembolism in 2 patients. Late follow-up echocardiography in all sur vivors showed a mean transaortic gradient of 13.6 +/- 6.7 mm Hg, and an aor tic valve area of 1.80 +/- 0.61 cm(2) Valve replacement was followed by a s ignificant and sustained decrease in left ventricular mass for all valve si zes. There has been no primary structural valve failure. Conclusions. The early experience with the Mosaic valve in the aortic posit ion has been promising. (C) 2000 by The society of Thoracic Surgeons.