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Long-term durability of pericardial valves in the aortic position in younger patients: when does reoperation become

Kenji Minakata1, Shiro Tanaka, Yoshiharu Takahara

  • 1Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Journal of Cardiac Surgery
|March 20, 2015
PubMed

Insights

Younger patients (<65 years) undergoing aortic valve replacement (AVR) with pericardial valves experienced structural valve deterioration (SVD) sooner than older patients. Reoperations for SVD became necessary around eight years post-AVR in younger individuals.

Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science
  • Medical Device Durability

Background:

  • Assessing long-term durability of pericardial valves in younger patients (<65 years) undergoing aortic valve replacement (AVR).
  • Determining the timing of reoperations due to structural valve deterioration (SVD) in this demographic.

Purpose of the Study:

  • To evaluate the long-term performance of pericardial valves in patients under 65 years old.
  • To compare SVD rates and reoperation timing between younger and older AVR patients.

Main Methods:

  • Retrospective analysis of 574 adult patients undergoing AVR with pericardial valves (1986-2001) in Japan.
  • Comparison of 53 patients aged <65 years (Group Y) with 521 patients aged ≥65 years (Group O).

Main Results:

  • Freedom from reoperation due to SVD was significantly lower in Group Y (47.2% at 15 years) compared to Group O (94.4% at 15 years).
  • The reoperation-free survival curve for Group Y began declining after eight years.
  • For the 12 patients in Group Y requiring reoperation, the mean time to reoperation was 12.1 years.

Conclusions:

  • Redo AVR due to SVD becomes necessary approximately eight years after initial surgery in patients <65 years old.
  • Nearly half of younger patients require reoperation for SVD within 15 years of AVR with pericardial valves.
Abstract

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