Late clinical and echocardiographic results with the Magna Ease? pericardial aortic bioprosthesis

OBJECTIVES The population of candidates to surgical aortic valve replacement (SAVR) is evolving. The Perimount Magna Ease (c) bioprosthesis has been introduced relatively recently in the practice. We aimed at evaluating its long-term results. METHODS This article describes a single-centre cohort of 1016 consecutive SAVRs with the Magna Ease (c) valve (2008-2014), consisting of an all-comers population. We performed a prospective collection of in-hospital data, systematic clinical and echocardiographic follow-up. Valve-related events were as follows: structural valve deterioration (SVD; according to modified definition criteria), nonstructural valve dysfunction, patient-prosthesis mismatch (PPM). RESULTS Age at SAVR was 73.4 +/- 9.5 years; calcified aortic stenosis was the indication to surgery in 59.6%. A total of 974 patients entered the follow-up; 564 were alive at the last follow-up (median duration: 9.8 years) (up to 13.4 years). New York Heart Association class was I or II in 92.1%. Overall survival at 10 years was 56.8 +/- 1.8%. Freedom from SVD at 10 was 96.5 +/- 0.8% (Kaplan-Meier) and 97.4 +/- 0.6% (competing risks) (28 SVD events after 6.9 +/- 3.3 years). There were 15 reinterventions for SVD (redo-SAVR and Transcatheter Aortic Valve Implantation (TAVI)); 10-year freedom from reintervention was 97.8 +/- 0.6%. Moderate and severe PPM occurred in 26.8% and 5.4%, respectively, without association with late mortality (P = 0.12 for moderate and P = 0.70 for severe PPM). Freedom from valve-related mortality was 97.8 +/- 0.5% at 10 years. CONCLUSIONS In this follow-up of the Magna Ease bioprosthesis for SAVR, data indicate good late outcomes (30-day outcomes are excluded). Continued follow-up is required to further support its use in patients with life expectancy >10-12 years.