Structural and Non-Structural Deterioration After Biological Aortic Valve Replacement: Long-Term Outcomes of 918...

Area of Science:

• Cardiology
• Cardiac Surgery
• Biomaterials Science

Background:

• Aortic valve disease presents a significant and growing global health burden.
• Surgical aortic valve replacement (AVR) using biological prostheses is a common treatment.
• Long-term outcomes, including structural deterioration, require ongoing assessment.

Purpose of the Study:

• To evaluate the long-term efficacy and durability of biological AVR.
• To assess rates of reoperation, structural deterioration, and non-structural complications.
• To compare outcomes between different biological prosthetic valve models.

Main Methods:

• Retrospective analysis of 918 patients undergoing surgical AVR with biological prostheses (2006-2009).
• Primary endpoints: freedom from reoperation and deterioration; Secondary endpoint: long-term survival.
• Median follow-up of 7.6 years (6610 patient-years).

Main Results:

• Freedom from reoperation at 5, 10, and 15 years was 97%, 95.6%, and 90.3%, respectively.
• Low rates of major stroke (96.4% at 10 years) and bleeding events (95.7% at 10 years).
• No significant differences in outcomes between Carpentier Edwards Perimount and Medtronic Mosaic valves.

Conclusions:

• Surgical AVR with biological prostheses offers good long-term survival in high-risk, elderly patients.
• Biological valves exhibit favorable long-term durability with low complication and reoperation rates.
• Surgical AVR remains a viable therapeutic option alongside newer interventions.