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SURGICAL VALVE SOLUTIONS

EPIC™ PLUS MITRAL AND AORTIC STENTED TISSUE VALVES CLINICAL DATA

The latest generation of the Epic™ Platform continues the Epic product family’s history of excellence. The future-forward design of the Epic Plus mitral and aortic valves gives you and your patients more choices when it comes to preserving long-term treatment paths.

DURABILITY THAT WITHSTANDS
THE LONG-TERM TEST OF TIME

At 10 Years

93.8%*

Freedom from SVD,
all patient ages (Epic™ Mitral VALVE)1

96.3%*

Freedom from SVD,
all patient ages (Epic™ Aortic VALVE)2

SVD: structural valve deterioration.
*From stand-alone aortic or mitral valve replacements.
 

THE EPIC PLATFORM HAS DEMONSTRATED EXCELLENT DURABILITY IN YOUNGER PATIENTS

The Epic™ Mitral valve experience from Rennes shows excellent performance in younger patients, with a 10-year freedom from SVD of 87.7% for the age ≤ 59 subgroup.3

 

87.7%

EPIC MITRAL VALVE
Freedom from SVD,
at 10 YEARS3

EPIC SUPRA VALVE DELIVERS EXCEPTIONAL DURABILITY AND PERFORMANCE

  • Optimal leaflet design minimizes regurgitation
  • Pericardial shield reduces abrasion by creating tissue-to-tissue interface
  • Epic valve 10-year durability data show outstanding aortic freedom from SVD2 

96.3%

EPIC AORTIC VALVE
Freedom from SVD,
at 10 YEARS2

STRONG IN VIVO HEMODYNAMICS

STRONG IN VIVO HEMODYNAMICS

*NOTE: For references 4-8, data not from head-to-head studies. Data differences depicted between these trials may not be directly comparable, statistically significant, or clinically meaningful due to differences in trial protocols, endpoints, and/or patient populations. Data provided for informational purposes only.
†Pressure Gradients approximated through Epic Aortic Valve SSED data matched with stent size equivalencies for the Epic Plus Supra Valve. Per Abbott Internal engineering specifications, a 19 mm Epic Plus Supra Valve has the same stent size as a 21 mm Epic™/Epic™ Plus Aortic Valve and this relationship continues across all Epic Plus Supra Valve sizes.
‡Indicates a third-party trademark, which is property of its respective owner.

MAT-2115621 v1.0 | Item approved for U.S. use only.

References
  1. Lehmann S, Jawad K, Meyer A, et al. Long-term follow-up after porcine xenograft mitral valve replacement. Presented at: 2017 American Association For Thoracic Surgery Mitral Conclave. April 27-28, 2017; New York, NY, USA.
  2. Lehmann, S, Merk DR, Etz CD, et al. Porcine xenograft for aortic, mitral and double valve replacement: long-term results of 2544 consecutive patients. Eur J Cardiothorac Surg. 2016;49:1150-1156.
  3. Anselmi A, Aymami M, Tomasi J et al. Durability of mitral valve replacement with a 3rd generation bioprosthesis. Ann Thorac Surg. 2021. doi: doi. org/10.1016/j.athoracsur.2021.03.097.
  4. Biocor Instructions for Use.
  5. Maitland A, Hirsch GA, and Pascoe EA. Hemodynamic performance of the St. Jude Medical Epic Supra Aortic Stented Valve. J Heart Valve Dis, 2011; 20:327-331.
  6. Mosaic Instructions for Use.
  7. Resilia Instructions for Use.
  8. Magna Ease Instructions for Use.
Important Safety Information

EPICTM PLUS/ EPICTM PLUS SUPRA STENTED PORCINE TISSUE VALVES
INDICATION FOR USE


The Epic™ Plus valve is indicated for patients requiring replacement of a diseased, damaged, or malfunctioning native aortic and/or mitral heart valve. It may also be used as a replacement for a previously implanted aortic and/or mitral prosthetic heart valve.
The Epic™ Plus Supra valve is indicated for patients requiring replacement of a diseased, damaged, or malfunctioning native aortic heart valve. It may also be used as a replacement for a previously implanted aortic prosthetic heart valve.

CONTRAINDICATIONS

None known.

WARNINGS

  • Valve size selection is based on the size of the recipient annulus, and for supra-annular aortic placement, the anatomy of the sinotubular space. Implantation of an inappropriately large bioprosthesis may result in stent deformation, valvular incompetence, valve damage, diminished tissue durability and/or damage to the surrounding tissues. The use of an inappropriately small bioprosthesis may result in suboptimal hemodynamics. Use only the E2000 Epic™ Plus Heart Valve Sizer Set with the Epic™ Plus and Epic™ Plus Supra valves.
  • Accelerated deterioration due to calcific degeneration of the Epic Plus and Epic Plus Supra valve may occur in:
    • children, adolescents, or young adults;
    • patients with altered calcium metabolism (e.g., patients with hyperparathyroidism or chronic renal failure); or
    • individuals requiring hemodialysis.
  • For single use only. Do not reuse or resterilize. Attempts to resterilize the valve may result in valve malfunction, inadequate sterilization, or patient harm.
  • Passage of a catheter or transvenous pacing lead through any bioprosthesis may damage the valve and is therefore not recommended.
  • Do not use if:
    • the valve has been dropped, damaged, or mishandled in any way, or if there is any sign of deterioration;
    • the expiration date has elapsed;
    • the tamper-evident container seal is damaged, broken, or missing, or if fluid is leaking from the packaging; or
    • the storage solution does not completely cover the valve.

PRECAUTIONS

  • The safety and effectiveness of the Epic™ Plus and Epic™ Plus Supra valves has not been established for the following specific populations:
    • patients who are pregnant
    • nursing mothers
    • patients with chronic renal failure
    • patients with aneurysmal aortic degenerative conditions (e.g., cystic medial necrosis, Marfan’s syndrome)
    • patients with chronic endocarditis
    • patients requiring pulmonic or tricuspid valve replacement
    • children, adolescents, or young adults
  • Sizers are supplied non-sterile, and must be cleaned and sterilized prior to each use. Do not use cracked, deformed, or damaged sizer set components.
  • Do not pass the flanged portion of the valve replica sizing tool through the annulus.
  • Do not place the non-sterile exterior of the valve container in the sterile field.
  • Do not expose the valve to solutions other than the formaldehyde valve storage solution in which it was shipped, the sterile isotonic saline solution used during the rinsing procedure, or the sterile isotonic saline solution used to irrigate the valve.
  • Do not add antibiotics to either the formaldehyde valve storage solution or the rinse solution.
  • Do not apply antibiotics to the valve.
  • Do not allow the valve tissue to dry. Place the valve in sterile isotonic saline rinse solution immediately upon removal from the valve storage solution. Once removed from this solution, the valve should be periodically irrigated during implantation.
  • Do not use the valve if shipping temperature indicators on the product carton have turned red, or if the valve has been improperly stored in temperature conditions outside of the 5 °C to 25 °C range.
  • Do not implant the valve without thoroughly rinsing as directed.
  • Do not lacerate the valve tissue. If a valve is damaged, the valve must be explanted and replaced.
  • Do not attempt to repair a valve. Damaged valves must not be used.
  • Do not use cutting edge needles, unprotected forceps, or sharp instruments as they may cause structural damage to valve.
  • Never handle the leaflet tissue.
  • Position the mitral valve in a manner to avoid commissure obstruction of the left ventricular outflow tract, and minimize any potential of commissure contact with the ventricular wall.
  • Position the aortic valve so that the stent posts do not obstruct the coronary ostia or come in direct contact with the aortic wall.
  • When implanting the Epic™ Plus heart valve, assess the suitability of the selected valve size and stent post position for a potential future valve-in-valve procedure and whether the transcatheter valve-in-valve procedure may result in left ventricular outflow tract or coronary ostia obstruction. For future valve-in-valve procedure in an Epic Plus valve, refer to the instructions for use supplied with the transcatheter heart valve along with reference dimensions in Table 1 (in the IFU) to determine compatibility. The safety and effectiveness of valve-in-valve procedures in an Epic™ Plus or an Epic™ Plus Supra valve have not been established.
  • Avoid prolonged contact with the formaldehyde storage solution. Immediately after contact, thoroughly flush any skin exposed to the solution with water. In case of contact with eyes, flush with water and seek appropriate medical care.

ADVERSE EVENTS

The clinical investigation of the Epic valve supports the safety and effectiveness of the Epic™ Plus valve and the Epic™ Plus Supra valve. Between January 2003 and March 2006, seven-hundred and sixty-two (762) subjects were implanted with 791 Epic Valve(s) at 19 investigational sites in the United States (U.S.), and three sites in Canada. Five-hundred and fifty-seven (557) subjects received isolated aortic replacement, 176 received isolated mitral replacement, and 29 received replacement of both the aortic and mitral valves. The cumulative follow-up for all subjects was 773.51 patient-years with a mean follow-up of 1.02 patient-years (s.d. = 0.71 patient-years, range 0 – 3.10 patient-years).

Potential Adverse Events

Adverse events potentially associated with the use of bioprosthesis heart valves (in alphabetical order) include: 

  • angina
  • cardiac arrhythmias
  • endocarditis
  • heart failure
  • hemolysis
  • hemolytic anemia
  • hemorrhage, anticoagulant/antiplatelet-related
  • leak, transvalvular or paravalvular
  • myocardial infarction
  • nonstructural dysfunction (entrapment by pannus or suture, inappropriate sizing or positioning, or other)
  • prosthesis regurgitation
  • stroke
  • structural deterioration (calcification, leaflet tear, or other)
  •  thromboembolism
  •  valve thrombosis

It is possible that these complications could lead to:

  •  reoperation
  •  explantation
  •  permanent disability
  •  death
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