Mitral Valve Replacement with a Third Generation Porcine Valve: an Italian Multicentered Study

Roberto Lorusso*, Antonio Miceli, Sandro Gelsomino, Antonio Lio, Orlando Parise, Andrea Montisci, Enrico Vizzardi, Davide Pacini, Roberto Di Bartolomeo, Attilio Renzulli, Filiberto G Serraino, Chiara Comoglio, Roberta Liberi, GianLuca Martinelli, Alfonso Sciangula, Alessandro Mazzola, Francesca Faragalli, Michele De Bonis, Maurizio Taramasso, Ottavio AlfieriPhilippe Caimmi, Ezio Micalizzi, Domenico Mercogliano, Gloria Demicheli, Michele Celiento, Uberto Bortolotti, Marco Solinas, Mattia Glauber

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Web of Science)


Background. Postoperative outcomes of a third-generation porcine bioprosthesis for mitral valve replacement (MVR) have been poorly addressed. The objective of this study was to perform an independent, retrospective, multicenter study on outcomes of patients undergoing MVR with a Mosaic (Medtronic Inc, Minneapolis, MN) porcine bioprosthesis.

Methods. From 1998 to 2011, 805 patients underwent MVR with a Mosaic porcine valve in 11 cardiac centers. There were 465 female patients (58%), and the overall mean age was 73.5 +/- 7 years. Associated procedures included coronary artery bypass grafting (201 patients; 24.9%), aortic valve replacement (152 patients; 18.9%), tricuspid annuloplasty (187 patients; 22.3%), and other cardiac procedures (116 patients; 14.4%).

Results. Median follow-up was 44 months (interquartile range, 16 to 63), with a cumulative duration of 2.769 patientyears. Early mortality for isolated elective MVR was 3.8% (12 of 313), and overall early mortality was 7.8% (n = 63). The rate of late mortality was 3.4%/patient-year (95 late deaths). At 10 years, overall survival was 57.4% (95% confidence interval [CI], 48.8% to 67.5%), and cumulative rates of cardiac- and valve-related death were 7.4% (95% CI, 4.8% to 10.1%) and 1.1% (95% CI, 0.2% to 1.9%), respectively. The 10-year cumulative rates of thromboembolic and hemorrhagic events were 6.6% (95% CI, 1.4% to 11.8%) and 3.9% (95% CI, 0.1% to 8%), respectively, and the 10-year cumulative incidence of prosthetic valve endocarditis was 3%(95% CI, 1.2% to 4.9%). Finally, the 10-year cumulative incidences of structuralvalve degeneration andreoperationswere5.8%(95% CI, 0.2% to 11.5%) and 4.8% (95% CI, 0.7% to 10.3%), respectively.

Conclusions. This independent, multicenter, retrospective study indicated that the Mosaic porcine bioprosthesis forMVR provides satisfactory results in terms of both early andlong-termoutcomes upto 14 years fromits implantation. (C) 2020 by The Society of Thoracic Surgeons

Original languageEnglish
Pages (from-to)1865-1872
Number of pages8
JournalAnnals of Thoracic Surgery
Issue number6
Early online date11 Oct 2019
Publication statusPublished - Jun 2020



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