Thorac Cardiovasc Surg 2019; 67(04): 274-281
DOI: 10.1055/s-0038-1660517
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Hemodynamic Results and Mid-term Follow-up of 850 19 to 23 mm Perimount Magna Ease Valves

Amedeo Anselmi
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Vito Giovanni Ruggieri
2  Division of Thoracic and Cardiovascular Surgery, Robert Debré University Hospital, Reims, France
,
Réda Belhaj Soulami
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Erwan Flécher
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Thierry Langanay
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Hervé Corbineau
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Alain Leguerrier
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
,
Jean-Philippe Verhoye
1  Division of Thoracic and Cardiovascular Surgery, Pontchaillou University Hospital, Rennes, France
› Author Affiliations
Further Information

Publication History

30 January 2018

14 April 2018

Publication Date:
01 August 2018 (online)

Abstract

Background Aortic valve replacement (AVR) in small aortic roots remains a surgical dilemma with a higher risk of patient-prosthesis mismatch (PPM). The Perimount Magna Ease aortic valve (PMEAV) represents an attractive device in such cases. We examined the early hemodynamic performance, the mid-term outcomes of the PMEAV, and the impact of PPM on outcome and functional class.

Methods We performed a retrospective analysis of prospectively collected in-hospital data, and a prospective single-center follow-up of 849 patients who received a 19 to 23 mm PMEAV (2008–2014). Concomitant mitral or tricuspid replacement was the exclusion criterion. Early hemodynamic features were prospectively collected; mid-term follow-up was conducted according to current guidelines.

Results Size of implanted prosthesis was 19 mm in 11.5% of patients, 21 mm in 36.9%, and 23 mm in 51.5%. Operative mortality was 4.5% (3.1% for isolated AVR). The rate of severe and moderate PPMs was significantly higher in the 19 mm group. Follow-up was 99.9% complete (3.7 ± 2 years). Actuarial freedom from structural valve deterioration (SVD) at 5 years was 99.1%. At stratified Kaplan–Meier's analysis, PPM and age <70 years were associated with SVD. PPM was not associated with worse functional status (New York Heart Association class) or mortality at follow-up.

Conclusion This series shows satisfactory clinical outcomes of the PMEAV implanted in small aortic annuli at mid-term follow-up. Although PPM may occur in smaller sizes, it has limited clinical impact, and it is not associated with mid-term mortality or worse functional class. Few SVD events are evidenced; nonetheless, limited follow-up duration and its methodology need to be considered.