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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Biological versus mechanical prostheses for aortic valve replacement.

Emiliano A Rodríguez-Caulo1, Oscar R Blanco-Herrera2, Elisabet Berastegui3

  • 1Cardiovascular Surgery Department, Virgen de la Macarena University Hospital, Sevilla, Spain.

The Journal of Thoracic and Cardiovascular Surgery
|March 13, 2021
PubMed
Summary
This summary is machine-generated.

For patients aged 50-65 undergoing aortic valve replacement, long-term survival was similar between biological and mechanical prostheses. Mechanical valves increased bleeding risk, while biological valves had higher reoperation rates.

Keywords:
aortic valve stenosisheart valve diseaselong-term adverse effectssurvival analysis

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Area of Science:

  • Cardiovascular Surgery
  • Biomaterials Science

Background:

  • Aortic valve replacement (AVR) decisions require long-term outcome data.
  • Choosing between biological (Bio) and mechanical (Mech) prostheses is critical for patients aged 50-65.

Purpose of the Study:

  • To compare long-term survival and major adverse cardiac and cardiovascular events (stroke, reoperation, major bleeding) for Bio vs. Mech prostheses in AVR patients aged 50-65.

Main Methods:

  • Multicenter observational study (2000-2018) of 5215 patients with severe isolated aortic stenosis.
  • 15-year follow-up with 2:1 propensity score matching (1822 Mech, 911 Bio).
  • Competing risks analyses were applied.

Main Results:

  • No significant difference in long-term survival between Bio and Mech prostheses.
  • Mechanical prostheses showed a trend towards higher stroke risk (P=0.07).
  • Higher rates of major bleeding with Mech prostheses (P=0.004); higher reoperation rates with Bio prostheses (P<0.001).

Conclusions:

  • Long-term survival is comparable for Bio and Mech prostheses in the 50-65 age group.
  • Mech prostheses are associated with increased bleeding risk; Bio prostheses with higher reoperation risk.
  • Biological prostheses represent a reasonable choice for AVR in this patient demographic in Spain.