A surgical team led by Arnar Geirsson, M.D., chief of the Division of Cardiac Surgery at NewYork-Presbyterian and Columbia, was one of the first in the country to implant a new bioprosthetic mitral valve that was recently approved by the Food and Drug Administration, using it to treat a patient with mitral valve regurgitation.
The Mosaic Neo valve is a next generation porcine valve that can be implanted via sternotomy, minimally invasive surgery, or robotic surgery. The device was designed to be a long-lasting option for valve disease patients who may not be candidates for mechanical valve replacement, which requires lifelong anticoagulation therapy.
“This is a further evolution of the bioprosthetic valve, where a reduced profile allows for easier delivery and more applicability for patients with complex mitral valve disease,” says Dr. Geirsson, who performed the initial case via sternotomy but has also since implanted the valve robotically.
Dr. Geirsson, center, and his team performed one of the first implantations of the new bioprosthetic valve in April.
Improving Ease of Use and Lifetime Patient Management
The new device adds features to the existing Mosaic platform that enhance the surgeon’s experience, including an improved sewing cuff, valve holder, strut suspension system, and intuitive orientation markers. The valve was redesigned with input from surgeons, including from NewYork-Presbyterian and Columbia, and its new lower implant profile makes it easier to perform small-incision procedures.
In addition to excellent hemodynamics and durability, the valve’s wide anterior leaflet, reduced stent post protrusion and improved visualization under fluoroscopy also makes left ventricular outflow tract (LVOT) clearance and preservation of the neo-LVOT possible, helping improve lifetime patient management. “The optimal valve design allows for the future application of transcatheter valves, if needed,” says Dr. Geirsson.
The Mosaic Neo’s low profile makes it more conducive to small-incision procedures. Image courtesy of Medtronic.
The Mosaic Neo was officially launched at a symposium at the annual meeting of the American Association for Thoracic Surgeons held in Chicago in May, where Dr. Geirsson shared his experiences with the valve. “At NewYork-Presbyterian and Columbia, we strive to offer our patients innovative technology,” says Dr. Geirsson. “We are proud to be among the first institutions to offer this new valve.”
