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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Aortic valve replacement: choice between mechanical valves and bioprostheses.
Shuli Silberman1, Avraham Oren, Moshe Dotan
1Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Jerusalem, Israel. ssilberman@szmc.org.il
Journal of Cardiac Surgery
|May 9, 2008
Summary
Mechanical vs. bioprosthetic aortic valve replacement shows similar long-term survival and event-free survival. Patient age alone should not determine the choice of valve substitute.
Area of Science:
- Cardiovascular Surgery
- Biomaterials Science
- Clinical Outcomes Research
Background:
- Aortic valve replacement (AVR) involves choosing between mechanical and bioprosthetic devices.
- Patient age is often the primary factor, but long-term outcomes require further comparison.
Purpose of the Study:
- To compare the long-term outcomes of mechanical versus bioprosthetic aortic valve replacement.
- To identify predictors of late mortality after AVR.
Main Methods:
- A retrospective review of 352 patients undergoing AVR between 1993 and 2004.
- 189 patients received mechanical valves, and 163 received bioprostheses.
- Outcomes assessed included late mortality, thrombo-embolic events, stroke, bleeding, valve thrombosis, endocarditis, and reoperation.
Main Results:
- No significant differences in operative mortality, morbidity, or long-term survival between the two groups.
- Event-free survival rates were comparable at 3, 5, and 10 years.
- Age at operation and renal failure were identified as the sole predictors of late mortality.
Conclusions:
- Mechanical and bioprosthetic aortic valve substitutes offer similar survival and event-free survival.
- Valve selection should consider life expectancy, patient preference, anticoagulation tolerance, lifestyle, and risks of bleeding and reoperation.
- Patient age should not be the sole determinant for choosing between mechanical and bioprosthetic valves.
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