Thorac Cardiovasc Surg 2012; 60(05): 326-333
DOI: 10.1055/s-0031-1299570
Original Cardiovascular
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Favorable Gradients with the Mitroflow Aortic Valve Prosthesis in Everyday Surgery

Martin Hartrumpf
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
,
Ralf Kuehnel
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
,
Michael Erb
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
,
Giorgi Loladze
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
,
Torsten Mueller
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
,
Johannes Albes
1  Department of Cardiovascular Surgery, Heart Center Brandenburg, Bernau bei Berlin, Germany
› Author Affiliations
Further Information

Publication History

04 April 2011

19 October 2011

Publication Date:
02 March 2012 (online)

Abstract

Background The supra-annular Mitroflow valve has been implanted for over 20 years, preferably in small aortic roots. Early outcomes and gradients in unselected elderly patients receiving aortic valve surgery are reported in this study.

Methods Mitroflow valves were implanted in 190 consecutive patients (70% females). Mean age was 75.6 ± 5.5 years, body mass index was 28.2 ± 5.3 kg/m2, and logistic EuroSCORE 17.8 ± 16.5%. There were 170 single, 17 double, and 3 triple valve procedures. Of all, 46.8% of surgeries were performed with coronary artery bypass grafting and 39.5% were performed with isolated aortic valve replacement (AVR). Rates of redo and endocarditic cases were 14.2 and 4.7%.

Results The 19-mm (n = 14), 21-mm (n = 135), and 23-mm (n = 41) valves showed mean gradients of 16.1 ± 7.4 mm Hg, 15.8 ± 7.1 mm Hg, and 11.6 ± 4.1 mm Hg, respectively, before discharge. Maximum gradients were 27.5 ± 13.0, 28.4 ± 12.6, and 21.6 ± 7.6 mm Hg, respectively. Correlation between gradients and sizes was significant. In-hospital mortality was 12.6% overall (6.7% in isolated AVR). The rate of valve-related events was low (mild paravalvular leakage 2.1%, neurologic 3.2%, bleeding 3.2%, atrioventricular block 4.2%, no thrombosis).

Conclusion The Mitroflow valve can be safely implanted in elderly patients undergoing advanced surgical procedures. Gradients were acceptably low even in the smallest valves.