Ten-Year Follow-Up of Mitral Valve Replacement With the Epic Porcine Valve in a Medicare Population

被引:1
作者
Rodriguez, Evelio [1 ]
Smith, Robert [2 ]
Castro, Luis [3 ]
Baker, Craig J. [4 ]
Yu, Yang [5 ]
Prillinger, Julie B. [5 ]
Gutfinger, Dan [5 ]
Starnes, Vaughn A. [4 ]
机构
[1] Ascens St Thomas Hosp, Dept Cardiac Surg, Nashville, TN USA
[2] Baylor Scott & White Heart Hosp, Div Cardiothorac Surg, Plano, TX USA
[3] Sequoia Hosp, Dept Cardiovasc Surg, Redwood City, CA USA
[4] Univ Southern Calif, Div Cardiac Surg, Keck Hosp, Los Angeles, CA USA
[5] Abbott, Santa Clara, CA USA
关键词
LONG-TERM SURVIVAL; GENDER-DIFFERENCES; REPAIR; OUTCOMES; FAILURE;
D O I
10.1016/j.athoracsur.2024.07.032
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Bioprosthetic surgical mitral valve replacement (SMVR) remains an important treatment option in the era of transcatheter valve interventions. This study presents 10-year clinical outcomes of Medicare beneficiaries who underwent SMVR with a contemporary low-profile mitral porcine valve. METHODS This was a single-arm observational study using Medicare fee-for-service claims data. Deidentified patients undergoing SMVR with the Epic mitral valve (Abbott) in the United States between January 1, 2008 and December 31, 2019 were selected by International Classification of Diseases, Ninth and Tenth Revision procedure codes and then linked to a manufacturer device tracking database. All-cause mortality, heart failure (HF) rehospitalization, and mitral valve reintervention (surgical or transcatheter valve-in-valve) were evaluated at 10 years by using the Kaplan-Meier method. RESULTS Among 75,739 Medicare beneficiaries undergoing SMVR during the study period, 14,015 received the Epic mitral valve (Abbott), 76.5% (10,720) of whom had underlying HF. The mean age was 74 +/- 8 years. Survival at 10 years in patients without preoperative HF was 40.4% (95% CI, 37.4%-43.4%) compared with 25.4% (95% CI ,23.8%-27.0%) for patients with HF (P < .001). The 10-year freedom from HF rehospitalization was 51.3% (95% CI, 49.4%-53.1%). Freedom from mitral valve reintervention was 91.4% (95% CI, 89.7%-92.7%) at 10 years. CONCLUSIONS This real-world nationwide study of Medicare beneficiaries receiving the Epic mitral valve demonstrates >90% freedom from all-cause valve reintervention and >50% freedom from HF rehospitalization at 10 years after implantation. Long-term survival and HF rehospitalization in this population with mitral valve disease treated with SMVR was found to be affected by underlying HF.
引用
收藏
页码:1027 / 1035
页数:9
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