EARLY AND MIDTERM OUTCOMES FOLLOWING AORTIC VALVE REPLACEMENT WITH MECHANICAL VERSUS BIOPROSTHETIC VALVES IN PATIENTS AGED 50 TO 70 YEARS

Authors

  • Rafael Rocha Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
  • Rui J. Cerqueira Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • Francisca Saraiva Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal
  • Sara Moreira Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • António S. Barros Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • Jorge Almeida Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • Mário J. Amorim Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • André P. Lourenço Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Anesthesiology, Centro Hospitalar Universitário São João, Porto, Portugal
  • Paulo Pinho Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal
  • Adelinho Leite-Moreira Department of Surgery and Physiology, Cardiovascular Research and Development Center, Faculty of Medicine of the University of Porto, Porto, Portugal; Department of Cardiothoracic Surgery, Centro Hospitalar Universitário São João, Porto, Portugal

DOI:

https://doi.org/10.48729/pjctvs.28

Abstract

Objectives: To compare 7-year survival and freedom from reoperation, as well as early clinical and hemodynamic outcomes, after surgical aortic valve replacement (SAVR) with mechanical or bioprosthetic valves in patients aged 50-70 years.

Methods: single-center retrospective cohort study including adults aged 50-70 years who underwent SAVR in 2012 with a mechanical or bioprosthetic valve. Median follow-up was 7 years. Univariable analyses were performed using Kaplan- -Meier curves and Log-Rank tests for survival and freedom from reoperation analyses. Multivariable time-to-event analyses were conducted using Cox Regression.

Results: Of a total of 193 patients, 76 (39.4%) received mechanical valves and 117 (60.6%) received bioprosthetic valves. A trend for better survival was found for mechanical prostheses when adjusting for EuroSCORE II (HR: 0.35; 95%CI: 0.12-1.02, p=0.054), but using a backward stepwise Cox regression prosthesis type was not retained by the model as an independent predictor of survival. Moreover, mechanical prostheses showed trends for higher freedom from reoperation (100% vs. 95.5%, Log-Rank, p=0.076), higher median EuroSCORE II (2.52% vs. 1.95%, p=0.06) and early mortality (7.9% vs. 2.6%, p=0.086). However, after adjusting for EuroSCORE II, there was no significant difference in early mortality (OR: 2.3, 95%CI: 0.5-10.5, p=0.272). Regarding hemodynamic performance at follow-up echocardiogram, there were no differences other than left ventricular mass regression, which was not as pronounced in the mechanical group (-12% vs. -21%, p=0.002).

Conclusion: Mechanical and bioprosthetic aortic valves prostheses showed similar mid-term survival in the 50-70 age group. Further prospective and larger studies are needed to provide evidence-based recommendations on this topic.

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Published

17-04-2021

How to Cite

1.
Rocha R, Cerqueira RJ, Saraiva F, Moreira S, Barros AS, Almeida J, Amorim MJ, Lourenço AP, Pinho P, Leite-Moreira A. EARLY AND MIDTERM OUTCOMES FOLLOWING AORTIC VALVE REPLACEMENT WITH MECHANICAL VERSUS BIOPROSTHETIC VALVES IN PATIENTS AGED 50 TO 70 YEARS. Rev Port Cir Cardiotorac Vasc [Internet]. 2021 Apr. 17 [cited 2024 May 22];27(3):179-8. Available from: https://pjctvs.com/index.php/journal/article/view/28

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