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Updated: Mar 15, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Choice of Aortic Valve Prosthesis in a Rapidly Aging and Long-Living Society
Yoshimasa Sakamoto1, Michio Yoshitake, Yoko Matsumura
1Department of Cardiac Surgery, Jikei University School of Medicine, Minato-Ku, Tokyo, Japan.
Purpose:
The aim of this study was to evaluate the long-term results of aortic valve replacement (AVR) with mechanical (M) and bioprosthetic (B) valves as recommended by the Japanese guidelines.
Methods:
From April 1995 to March 2014, 366 adult patients underwent AVR. Of these, 127 (35%) patients received M and 239 patients (65%) received B valves. A retrospective analysis of the entire and the selected 124 patients aged 60 to 70 years was carried out.
Results:
In patients aged 60 to 70 years, the 15-year survival and freedom from reoperation were 88% ± 7% and 100% for the M group and 34% ± 25% (p <0.001) and 73% ± 14% (p = 0.059) for the B group, respectively. Among propensity score matching of the subgroup, there was no significant difference in survival and freedom from reoperation. The rate of thromboembolism was higher in the M (M: 0.58% vs B: 0.35% patient per year, p <0.001) and the rate of hemorrhage was higher in the M group (M: 0.34% vs B: 0.12% patient per year, p <0.001).
Conclusion:
The current strategy of aortic valve choice based on the Japanese guidelines has provided excellent long-term results so far.
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