Abstract
This study retrospectively evaluated the mid-term outcomes of surgical aortic valve replacement (SAVR) using a stented porcine aortic valve bioprosthesis (Mosaic; Medtronic Inc., Minneapolis, MN, USA) with concomitant mitral valve (MV) repair. From 1999 to 2014, 157 patients (median [interquartile range] age, 75 [70–79] years; 47% women) underwent SAVR with concomitant MV repair (SAVR + MV repair), and 1045 patients (median [interquartile range] age, 76 [70–80] years; 54% women) underwent SAVR only at 10 centers in Japan as part of the long-term multicenter Japan Mosaic valve (J-MOVE) study. The 5-year overall survival rate was 81.5% ± 4.1% in the SAVR + MV repair group and 85.1% ± 1.4% in the SAVR only group, and the 8-year overall survival rates were 75.2% ± 5.7% and 78.1% ± 2.1%, respectively. Cox proportional hazards analysis showed no significant difference in the survival rates between the two groups (hazard ratio, 0.87; 95% confidence interval, 0.54–1.40; P = 0.576). Among women with mild or moderate mitral regurgitation who were not receiving dialysis, those who underwent SAVR + MV repair, were aged > 75 years, and had a preoperative left ventricular ejection fraction of 30–75% tended to have a lower mortality risk. In conclusion, this subgroup analysis of the J-MOVE cohort showed relevant mid-term outcomes after SAVR + MV repair.
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Data availability
The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We thank Ryan Chastain-Gross, Ph.D., and Angela Morben, D.V.M., E.L.S., from Edanz (https://jp.edanz.com/ac) and Elsevier Language Editing Services (https://webshop.elsevier.com/language-editing-services/language-editing) for editing a draft of this manuscript. We also thank Elsevier Webshop Illustration Services (https://webshop.elsevier.com/illustration-services) for drafting the tables, Andy Brandt, Ph.D., Aimee Talarski, Ph.D., and the American Journal Experts Illustration team (https://www.aje.com/jp/services/figures/) for drafting the figures, and Wyshena G, Ph.D. from American Journal Experts (https://www.aje.com) for final editing support. The reviewers’ comments helped to progress the research by initiating constructive discussions, including some rebuttals. This publication is dedicated to Taketo Hara, an old friend, and Toshio Nagai, a former patient.
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HS was a major contributor in producing and proposing the theme of this subgroup analysis, writing the manuscript, and drafting the tables. YY was managed the J-MOVE study and contributed to the subgroup analysis of mild or moderate MR. KY helped with the statistical analysis and the drafting of the figures. TN, one of HS’s mentors, is the head of the Department of Cardiovascular Surgery at New Tokyo Hospital and the operating surgeon in the present study. Y Okada, Y Okita, JK, HU, TK, and TS provided constructive critical advice regarding the manuscript. Academic lectures by Y Okita, HY, ST, and TI were consulted in HS’s work. TN, Y Okada, Y Okita, HY, JK, HU, ST, TI, TK, TS, and YY were operating surgeons in the present study. TN, Y Okita, HY, JK, HU, ST, TI, TK, TS, and YS were the heads of the departments of the 10 centers included in the J-MOVE registry. Y Okada was the vice principal investigator of the J-MOVE study. YS was the principal investigator of the study and organized some of the academic lectures. All authors have read and approved the final manuscript.
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The main hospital’s Research Ethics Committee (reference number 0086) and the local institutional review board of each participating center reviewed and approved this study.
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Sugimori, H., Nakao, T., Okada, Y. et al. Mid-term outcomes of surgical aortic valve replacement using a mosaic porcine bioprosthesis with concomitant mitral valve repair. Heart Vessels 39, 252–265 (2024). https://doi.org/10.1007/s00380-023-02325-x
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DOI: https://doi.org/10.1007/s00380-023-02325-x