(P250) CONTEMPORARY 3-YEAR REAL-WORLD OUTCOMES FOLLOWING MITRAL AND TRICUSPID VALVE REPLACEMENT WITH A NOVEL MITRAL TISSUE BIOPROSTHESIS

Background: Innovations in bovine pericardial tissue valves are promising. Specifically, Resilia bovine pericardial tissue valves (Edwards Lifesciences) incorporate a novel tissue technology, including stable capping of free aldehydes to prevent binding with calcium and glycerolization of the tissue to allow for dry storage. To date, mid-term outcomes of the COMMENCE mitral trial investigating mitral valve replacement using bioprosthesis with a novel Resilia tissue reported promising outcomes. However, the hemodynamics characteristics and potential durability of this new tissue treatment is still to be described in a real-world setting.

METHODS AND RESULTS: A retrospective review was conducted on the first patients undergoing mitral (MVR) or tricuspid valve replacement (TVR) with the Mitris Resilia bioprosthesis between July 2021 and March 2024. Follow-up included clinical assessments and echocardiography at immediate postoperative and follow-up period. Statistical methods, including mean values and Kaplan-Meier survival curve including 95% Cis were employed.
247 MVR and 76 TVR patients were included. For the MVR cohort, the mean age was 72.7 ± 9.3 years, and the STS predictive mortality and EuroSCORE II were 7.3 ± 6.3 and 8.7 ± 7.8, respectively. The 30-day mortality was 7.7%, while the 30-day complications included 6 strokes (3.0%), 1 endocarditis (0.4%), and 2 reoperations (1%). Follow-up was 658 ± 233 days, the late mortality rate was 0.0 %, and the late complications included 1 stroke (0.5%), 1 endocarditis (0.5%), and 1 reoperation (0.5%). Post-operative and late mean gradient pressure ranged from 3.68 to 5.8 mmHg and 4.28 to 4.5, respectively. For the TVR cohort, the mean age was 69.8 ± 11.8 years. The Triscore, STS predictive mortality and EuroSCORE II were 12.1 ± 7.5, 5.6 ± 5.0 and 8.0 ± 8.2, respectively. The 30-day mortality was 13.1%, while the 30-day complications included 4 strokes (6.0%). Follow-up was 551 ± 249 days, the late mortality rate was 0.0%, and the late complications included 1 endocarditis (1,6%). Post-operative and late mean gradient pressure ranged from 4.08 to 5 mmHg and 3.0 to 4.12, respectively.

Conclusion: This study demonstrated favorable hemodynamic and clinical outcomes in the short-term follow-up patients who underwent MVR or TVR using the novel tissue-mitral bioprothesis. These findings highlight the considerable potential of this new valve, particularly for cases involving severely clinically comorbid and irrepairable mitral and tricuspid valves planned for valve replacement at index procedure. Further studies are needed and the Momentis trial, which is underway, will look more extensively at the long-term follow-up of these prostheses.