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Long-term follow-up after isolated aortic valve replacement

J G Copeland, R B Griepp, E B Stinson

    The Journal of Thoracic and Cardiovascular Surgery
    |December 1, 1977
    PubMed
    Summary

    Aortic valve replacement is recommended for severe aortic regurgitation. Porcine xenograft valves show excellent long-term survival and fewer complications in patients undergoing aortic valve surgery.

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    Area of Science:

    • Cardiovascular Surgery
    • Biomaterials Science
    • Clinical Outcomes Research

    Background:

    • Isolated aortic valve replacement (AVR) is a critical procedure for severe aortic regurgitation.
    • Evaluating long-term outcomes and prosthetic valve performance is essential for surgical decision-making.

    Purpose of the Study:

    • To assess the long-term survival and complication rates following isolated aortic valve replacement.
    • To identify preoperative factors influencing patient survival after AVR.
    • To compare the outcomes of different prosthetic valve types, including mechanical and biological options.

    Main Methods:

    • Retrospective analysis of 1,127 patients undergoing isolated AVR between 1963 and 1976.
    • Inclusion of various prostheses: Starr-Edwards (Models 1000, 1200, 1260, 2320), homografts, and porcine xenografts.

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  • Mean follow-up of 4.4 years, with actuarial analysis of mortality and complications.

    • Main Results:

    • Overall mortality rate was 7.6%, with a subsequent annual attrition rate of 2.7%.
    • Significant preoperative predictors of long-term survival included age, heart failure, cardiac enlargement, myocardial infarction history, and hemodynamic parameters.
    • Porcine xenograft valves demonstrated excellent outcomes, suggesting they are a favorable choice for AVR.

    Conclusions:

    • Aortic valve replacement is indicated for asymptomatic severe aortic regurgitation.
    • Porcine xenograft valves are associated with favorable long-term survival and a low complication rate.
    • Preoperative patient characteristics significantly impact survival outcomes after aortic valve replacement.