The Medtronic Mosaic prothesis in aortic and mitral position: Clinical perfomance in 1540 patients up to 13 years

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Objectives: The MOSAIC bioprosthesis is a third generation stented porcine bioprosthesis, built upon the historical durability of the HANCOCK-II bioprosthesis. The MOSAIC Aortic and Mitral bioprostheses are preserved in buffered 0.2% glutaraldehyde in a zero pressure procedure and they are treated with the AOA (amino oleic acid) antimineralisation process, to improve hemodynamic performance and durability. Methods: Between 1/2000 and 12/2011 1540 patients received Mosaic bioprosthesis, male n = 884, female n = 656. Mean age was 68.8 years, range 11.3-92.1 years. 1347 patients received AVR (aortic valve replacement); male n = 791, female n = 556, mean age was 68.53 years, range 11.3-92.1 years.193 patients received MVR (mitral valve replacement), male n = 93, female n = 100. Mean age was 67.8 years, range 14.2-87.6 years). Perioperative data were collected prospectively and postoperative, follow-up was performed by a questionnaire or/and telephone interview between 2/2012 and 8/2013. Results: Follow-up was complete in 979 (72.7%) AVR patients and in 147 (76.2%) MVR patients. Early results for AVR and MVR were: mortality 1.9% and 3.6%; stroke 0.1% and 0.0%; rethoracotomy for bleeding 4.0% and 6.5%. Late results were: mortality 20.2% and 20.7%; stroke 0.97% and 1.04%; re-operation in 1.7% (endocarditis 0.4%) and 3.6% (endocarditis 0.5%). 689 patients with AVR (97.5%) and 105 patients with MVR (98.1%) were satisfied with the operative result. In NYHA class I 552 (78.1%) patients stayed in the AVR group and 78 (72.9%) patients in the MVR group, in II 88 (12.5%) and 16 (15.0%), in III 42 (5.9%) and 9 (8.4%), and in IV 3 (0.4%) and 0 patients. Conclusions: Our long-term results demonstrate clinical safety and excellent performance of the MOSAIC bioprosthesis during 13 years follow up. A high number of patients is satisfied with the operative results combined with a good late outcome.

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