Universität zu Köln

Eghbalzadeh, Kaveh, Kuhn, Elmar W. ORCID: 0000-0001-6301-7422, Gerfer, Stephen ORCID: 0000-0002-6568-6766, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Rahmanian, Parwis, Mader, Navid and Wahlers, Thorsten C. W. . Ten-Year Long-Term Analysis of Mechanical and Biological Aortic Valve Replacement. Thorac. Cardiovasc. Surg.. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-1902

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Abstract

Background For patients undergoing aortic valve replacement (AVR), structural valve deterioration (SVD) of a bioprosthesis (BP) is substantially accelerated in younger patients and valve-in-valve implantation is not always a considerable option. The risk-benefit assessment between SVD versus the risk of bleeding and thromboembolic events in patients with a mechanical prosthesis (MP) resulted in an age limit shift irrespective of inconsistent results reported in literature. Method This retrospective single-center study compared 10-year long-term outcomes in patients undergoing isolated AVR with MP or BP. The risk-adjusted comparison of patients undergoing isolated AVR ( n = 121) was performed after 1:1 propensity score matching (PSM) for age, sex, endocarditis, and chronic renal impairment (caliper of 0.2) leading to 29 pairs. Short- and long-term outcomes with respect to reoperation, major bleeding, stroke, all-cause and cardiovascular mortality, and overall survival at 10 years were analyzed. Results After PSM, groups were comparable with respect to preoperative characteristics, including patients with a mean age of 65 +/- 3 years (MP) and 66 +/- 4 years (BP) and an incidence rate of 6.9% for infective endocarditis in both cohorts. Short-term outcomes (transient neurologic disorder = 0.0 vs. 6.9%; stroke = 0.0%; in-hospital mortality = 3.4%) and in-hospital stays were comparable between MP and BP. Conclusion After isolated AVR with MP and BP, 10-year long-term outcomes were comparable in the reported single-center cohort. MP can still be implanted safely without a disadvantage as regards long-term survival.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eghbalzadeh, Kaveh UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar W. UNSPECIFIED orcid.org/0000-0001-6301-7422 UNSPECIFIED Gerfer, Stephen UNSPECIFIED orcid.org/0000-0002-6568-6766 UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Rahmanian, Parwis UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten C. W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-660543
DOI:	10.1055/s-0042-1744477
Journal or Publication Title:	Thorac. Cardiovasc. Surg.
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-1902
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PATIENTS AGED 50; OUTCOMES; TRANSCATHETER; REGURGITATION; PROSTHESES Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66054