{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:36:36Z","timestamp":1790202996426,"version":"4.1.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,3,28]],"date-time":"2022-03-28T00:00:00Z","timestamp":1648425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"CryoLife, Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study reports long-term clinical outcomes\u2014up to 17 years\u2014among patients undergoing mitral valve replacement with the On-X bileaflet mechanical valve. Prior data regarding long-term outcomes with the On-X mitral valve have been limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This retrospective observational study included all patients who underwent mitral valve replacement with the On-X (Standard or Conform-X) valve at 2 major Spanish cardiac surgery centres between 2001 and 2018. The primary study end point was freedom from death. The secondary study end points included surgical mortality and freedom from any valve-related events. Data were obtained from an institutional database, medical records review, direct telephone interviews or the Spanish population registry. Statistical and Kaplan\u2013Meier analyses were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>A total of 661 patients (mean age 63.1 \u00b1 10.9 years, 63% female) were followed for a mean of 5.6 years (range, 0\u201317.4 years). Survival at 5, 10 and 15 years was 85%, 71% and 63%, respectively. Surgical mortality was 7.3% (48\/661). The linearized rate of global mortality was 1.3% patient-year. Freedom from reoperation was 97%, 95% and 92% at 5, 10 and 15 years, respectively; freedom from anticoagulation-related events was 94%, 89% and 89%, respectively. Multivariable analysis showed that mortality increased with total length of stay, age, smoking history, severe pulmonary hypertension and a permanent pacemaker. Patients who received the On-X 25 -mm valve had decreased long-term survival relative to patients who received other On-X valve sizes, possibly due to underlying risk factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Patients in this study showed good long-term survival and freedom from valve-related events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac157","type":"journal-article","created":{"date-parts":[[2022,2,24]],"date-time":"2022-02-24T20:12:44Z","timestamp":1645733564000},"source":"Crossref","is-referenced-by-count":5,"title":["Long-term outcomes with the On-X bileaflet mitral valve: clinical events up to 17 years in 661 patients"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3277-4310","authenticated-orcid":false,"given":"Guillermo","family":"Reyes","sequence":"first","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario La Princesa , c\/Diego de Le\u00f3n 62 ; 28006, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario La Princesa , c\/Diego de Le\u00f3n 62 ; 28006, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-0953","authenticated-orcid":false,"given":"Emilio","family":"Monguio","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario La Princesa , c\/Diego de Le\u00f3n 62 ; 28006, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Berastegui","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Camara","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"de Antonio","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario La Princesa , c\/Diego de Le\u00f3n 62 ; 28006, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignasi","family":"Julia","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Fernanda","family":"Aguirre","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario La Princesa , c\/Diego de Le\u00f3n 62 ; 28006, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Badia","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0272-1704","authenticated-orcid":false,"given":"Christian","family":"Mu\u00f1oz-Guijosa","sequence":"additional","affiliation":[{"name":"Cardiac Surgery Department, Hospital Universitario Germans Trias i Pujol , Crta.Canyet; 08916 Badalona; Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,28]]},"reference":[{"key":"2022102811595095600_ezac157-B1","article-title":"Mitral valve disease: when should we call in the cardiac surgeon?","volume":"16","author":"Sayeed","year":"2018","journal-title":"E-Journal of Cardiology Practice"},{"key":"2022102811595095600_ezac157-B2","doi-asserted-by":"crossref","first-page":"e25","DOI":"10.1016\/j.jacc.2020.11.018","article-title":"2020 ACC\/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"77","author":"Otto","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2022102811595095600_ezac157-B3","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1093\/ejcts\/ezab389","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"60","author":"Vahanian","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022102811595095600_ezac157-B4","article-title":"Mitral valve incompetence: epidemiology and causes","author":"Ancona","year":"2018","journal-title":"E-Journal of Cardiology Practice"},{"key":"2022102811595095600_ezac157-B5","doi-asserted-by":"publisher","first-page":"e0221263","DOI":"10.1371\/journal.pone.0221263","article-title":"Trends, characteristics, in-hospital outcomes and mortality in surgical mitral valve replacement among patients with and without COPD in Spain (2001-2015)","volume":"14","author":"de-Miguel-D\u00edez","year":"2019","journal-title":"PLoS One"},{"key":"2022102811595095600_ezac157-B6","doi-asserted-by":"crossref","first-page":"1847","DOI":"10.1056\/NEJMoa1613792","article-title":"Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement","volume":"377","author":"Goldstone","year":"2017","journal-title":"N Engl J Med"},{"key":"2022102811595095600_ezac157-B7","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jtcvs.2013.08.028","article-title":"Mechanical versus bioprosthetic mitral valve replacement in patients &lt;65 years old","volume":"147","author":"Kaneko","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022102811595095600_ezac157-B8","first-page":"626","article-title":"Pure pyrolytic carbon: preparation and properties of a new material, On-X carbon for mechanical heart valves prostheses","volume":"7","author":"Ely","year":"1998","journal-title":"J Heart Valve Dis"},{"key":"2022102811595095600_ezac157-B9","doi-asserted-by":"crossref","first-page":"S1312","DOI":"10.1016\/S0003-4975(02)03968-1","article-title":"On-X Prosthesis Heart Valve Trial. 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Do They Differ?","volume":"68","author":"Barrios","year":"2015","journal-title":"Rev Esp Cardiol (Engl Ed)"},{"key":"2022102811595095600_ezac157-B18","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1007\/s12574-017-0341-9","article-title":"Right atrial myocardial deformation by two-dimensional speckle tracking echocardiography predicts recurrence in paroxysmal atrial fibrillation","volume":"15","author":"Govindan","year":"2017","journal-title":"J Echocardiogr"},{"key":"2022102811595095600_ezac157-B19","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/icvts\/ivw196","article-title":"Bileaflet mechanical valve replacement: an assessment of outcomes with 30 years of follow-up","volume":"23","author":"Saito","year":"2016","journal-title":"Interact CardioVasc Thorac Surg"},{"key":"2022102811595095600_ezac157-B20","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1016\/j.jtcvs.2009.07.039","article-title":"Fifteen years of experience with ATS mechanical heart valve prostheses","volume":"139","author":"Sezai","year":"2010","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022102811595095600_ezac157-B21","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.ejcts.2010.03.060","article-title":"The Sorin Bicarbon over 15 years clinical outcomes: multicentre experience in 1704 patients","volume":"38","author":"Azarnoush","year":"2010","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022102811595095600_ezac157-B22","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/j.jtcvs.2014.01.004","article-title":"Reduced anticoagulation after mechanical aortic valve replacement: interim results from the prospective randomized On-X valve anticoagulation clinical trial randomized FDA investigational device exemption trial","volume":"147","author":"Puskas","year":"2014","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2022102811595095600_ezac157-B23","doi-asserted-by":"crossref","first-page":"2717","DOI":"10.1016\/j.jacc.2018.03.535","article-title":"Anticoagulation and Antiplatelet Strategies After On-X Mechanical Aortic Valve Replacement","volume":"71","author":"Puskas","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2022102811595095600_ezac157-B24","author":"Randomized On-X Anticoagulation Trial (PROACT)","year":"2021"}],"container-title":["European Journal of Cardio-Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/5\/ezac157\/46668035\/ezac157.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ejcts\/article-pdf\/62\/5\/ezac157\/46668035\/ezac157.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,28]],"date-time":"2022-10-28T12:52:11Z","timestamp":1666961531000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ejcts\/article\/doi\/10.1093\/ejcts\/ezac157\/6555063"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,28]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,10,4]]}},"URL":"https:\/\/doi.org\/10.1093\/ejcts\/ezac157","relation":{},"ISSN":["1010-7940","1873-734X"],"issn-type":[{"value":"1010-7940","type":"print"},{"value":"1873-734X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2022,3,28]]},"article-number":"ezac157"}}