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Aortic valve replacement in patients aged 50 to 69 years: Analysis using Korean National Big Data

Min-Seok Kim1, Hae Rim Kim2, Seung Hyun Lee3

  • 1Department of Thoracic and Cardiovascular Surgery, Cardiovascular Center, Myongji Hospital, Hanyang University College of Medicine, Seoul, Korea.

Journal of Cardiac Surgery
|September 2, 2022
PubMed

Insights

For patients aged 50-69 undergoing aortic valve replacement (AVR), bioprosthetic valves showed similar long-term survival and cardiac mortality rates compared to mechanical valves. Reoperations were more common with bioprosthetic valves, while bleeding was more frequent with mechanical valves.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Biomaterials Science

Background:

  • Aortic valve replacement (AVR) is a critical procedure for managing aortic valve disease.
  • The choice between mechanical valves and bioprosthetic valves involves balancing long-term durability against risks of anticoagulation and bleeding.

Purpose of the Study:

  • To compare clinical outcomes and long-term survival after isolated AVR in patients aged 50-69 years.
  • To evaluate the comparative effectiveness of mechanical versus bioprosthetic valves in this patient cohort.

Main Methods:

  • A retrospective study using the Korean National Health Information Database (2002-2018).
  • Included 4732 patients aged 50-69 years who underwent isolated AVR.
  • Propensity score-matched analysis created two groups of 1429 patients each: bioprosthetic (Group B) and mechanical (Group M) valves.

Main Results:

  • Overall survival rates at 5 and 10 years were similar between Group B (87.8%, 75.2%) and Group M (91.2%, 76.7%).
  • Freedom from cardiac death rates at 5 and 10 years were also comparable (Group B: 95.6%, 92.4%; Group M: 96.0%, 92.1%).
  • Reoperations were significantly higher in Group B (p=0.007), while major bleeding was higher in Group M (p=0.039).

Conclusions:

  • Bioprosthetic valves demonstrate comparable long-term survival and cardiac mortality-free survival to mechanical valves in patients aged 50-69 undergoing isolated AVR.
  • The choice of valve type influences specific complication risks, with bioprosthetic valves associated with higher reoperation rates and mechanical valves with increased bleeding risk.
Abstract

Keywords:
valve repair/replacement

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