Post operative echocardiographic follow up after mitral valve replacement by different types of biological valves

Objectives This retrospective study compares porcine with bovine bioprosthesis in mitral position with regard to valvular degeneration. Methods Between 2005 and 2019, 15 patients underwent mitral valve replacement with porcine Epic biological valve (St-Jude) and 15 patients underwent mitral valve replacement by bovine Carpentier –Edwards Perimount biological valve and follow up ecocardiogarphy was done to evaluate valvular degeneration of both types Results Bovine type showed longer durability than porcine and less valvular degeneration within 14 years of follow up regardless age of patient, cause of valve replacement, or lesion of valve Coclusion: Bovine bioprothesis are better than porcine regarding durability

The study of dry biological valve crosslinked with a combination of carbodiimide and polyphenol

The glutaraldehyde crosslinked pericardium has been used in bioprosthetic valves for about 50 years. However, problems such as glutaraldehyde residue and calcification still exist in current commercial products. Non-glutaraldehyde crosslinked dry valve is an important strategy to solve those problems. In this study, a non-glutaraldehyde crosslinked dry biological valve material was obtained by the combined crosslinking of carbodiimide (EDC) and polyphenol. The results showed that the comprehensive properties of EDC and curcumin crosslinked pericardium were superior to glutaraldehyde crosslinked pericardium, including unfolding property, anti-calcification, cytotoxicity, anticoagulant properties, mechanical properties, enzyme degradation resistance and thermal shrinkage temperature. EDC and curcumin crosslinked dry pericardium could flatten after being folded at 40°C for 3 days while glutaraldehyde crosslinked pericardium could not. The calcification of pericardium treated with EDC and curcumin was 1.21 ± 0.36 mg/g in rats after 60 days’ subdermal implantation, much lower than that of glutaraldehyde treated control group (22.06 ± 3.17 mg/g).

Abstract 15993: Survival Benefit of Mechanical Valve Over Biological Valve for Isolated Mitral Valve Replacement in Young Dialysis Patients: National Database Analysis

Introduction: Optimal valve choice for mitral valve replacement (MVR) in dialysis patients remains unclear. Hypothesis: Mechanical valve (MV) provides survival benefit over biological valve (BV) in young dialysis patients who are undergoing MVR. Methods: Using the United States Renal Data System, a total of 2,905 patients were found to have undergone isolated MVR from 2000 through 2015. Median follow up period was 1.27 years (IQR: 0.23-3.33). We stratified patients into 3 groups by age, and adjusted baseline characteristics between patients who received BV and MV using propensity score matching in each age group: Group1, 18 to 49 (n=456); Group2, 50 to 69 (n=1030); and Group3, 70 or older (n=338). Primary endpoint was 10-year mortality. Cox-hazard model was used to compare 10-year mortality between BV and MV in matched cohorts. Results: Overall in-hospital and 10-year mortality rates were 16.8% and 87.1%, respectively. Use of BV increased from 17.8% in 2000 to 47.2% in 2015 (Figure 1). In the propensity matched groups, Cox hazard analysis revealed BV was independently associated with higher risk of mortality in Group1 (HR 1.51, 95% CI 1.22-1.86, P<0.001), but not for Group 2 (HR 1.01, 95% CI 0.88-1.15, P=0.88) or Group 3 (HR 0.9, 95% CI 0.72-1.13, P=0.37) (Figure 2). Conclusions: MV is associated with better long-term survival over BV in well-matched young dialysis patients who are undergoing isolated MVR.