title: A North American, prospective, multicenter assessment of the Mitroflow aortic pericardial prosthesis.
abstract: BACKGROUND
  The aim of the Mitroflow aortic pericardial valve study was to prospectively assess performance of the Mitroflow prosthesis among North American patients.
  
  
  METHODS
  The study was conducted between November 2003 and December 2007 on patients requiring aortic valve replacement. The study cohort consisted of 689 patients (391 male, 298 female), with a mean age of 74.3 +/- 8.4 years, and 46.6% of whom were New York Heart Association (NYHA) class I/II preoperatively. Patients were followed at 3 to 6 months and yearly until study closure. Mean follow-up was 25.7 +/- 12 months, and total follow-up was 1,474.4 patient-years, with a maximum of 48.7 months.
  
  
  RESULTS
  Postoperatively, more than 97% of evaluated patients were NYHA class I/II. At 3 years, 131 patients had died, for an actuarial survival of 79.1%; and the 3-year actuarial freedom from valve-related death, valve explant, all valve reoperation, and structural valve dysfunction was 97.0%, 98.1%, 97.9%, and 99.2%, respectively. Other valve-related complications included prosthetic valve endocarditis (1.4% per patient-year), thromboembolic episodes (1.3% per patient-year), major embolism (0.5% per patient-year), perivalvular leak (0.6% per patient-year), and major anticoagulation-related bleeding (0.6% per patient-year). Echocardiograms at 1 year showed mean pressure gradients averaged from 7.3 +/- 1.8 mm Hg to 13.4 +/- 5.1 mm Hg, and peak gradients averaged from 14.3 +/- 4.7 mm Hg to 26.0 +/- 9.2 mm Hg for valve sizes 27 to 19. Aortic regurgitation in patients was absent/trace (90.2%) or mild (8.7%); none was severe.
  
  
  CONCLUSIONS
  The early results of this study show a low incidence of valve-related adverse events and excellent hemodynamic performance. Continued follow-up is needed to determine if long-term durability in North American patients is comparable to that in previous reports on the durability of the Mitroflow valve.
authors.affiliation: Division of Cardiac Surgery, Johns Hopkins Hospital, Baltimore, Maryland 21205, USA. jconte@csurg.jhmi.jhu.edu
authors.forename: John
authors.initials: J
authors.lastname: Conte
authors.forename: Neil
authors.initials: N
authors.lastname: Weissman
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Dearani
authors.forename: Joseph
authors.initials: J
authors.lastname: Bavaria
authors.forename: David
authors.initials: D
authors.lastname: Heimansohn
authors.forename: Walter
authors.initials: W
authors.lastname: Dembitsky
authors.forename: Daniel
authors.initials: D
authors.lastname: Doyle
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009656:North America; D011446:Prospective Studies