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Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients.

Publication ,  Journal Article
Peterseim, DS; Cen, YY; Cheruvu, S; Landolfo, K; Bashore, TM; Lowe, JE; Wolfe, WG; Glower, DD
Published in: J Thorac Cardiovasc Surg
May 1999

OBJECTIVE: The purpose of this study was to optimize selection criteria of biologic versus mechanical valve prostheses for aortic valve replacement. METHODS: Retrospective analysis was performed for 841 patients undergoing isolated, first-time aortic valve replacement with Carpentier-Edwards (n = 429) or St Jude Medical (n = 412) prostheses. RESULTS: Patients with Carpentier-Edwards and St Jude Medical valves had similar characteristics. Ten-year survival was similar in each group (Carpentier-Edwards 54% 3% versus St Jude Medical 50% 6%; P =.4). Independent predictors of worse survival were older age, renal or lung disease, ejection fraction less than 40%, diabetes, and coronary disease. Carpentier-Edwards versus St Jude Medical prostheses did not affect survival (P =.4). Independent predictors of aortic valve reoperation were younger age and Carpentier-Edwards prosthesis. The linearized rates of thromboembolism were similar, but the linearized rate of hemorrhage was lower with Carpentier-Edwards prostheses (P <.01). Perivalvular leak within 6 months of operation was more likely with St Jude Medical than with Carpentier-Edwards prostheses (P =.02). Estimated 10-year survival free from valve-related morbidity was better for the St Jude Medical valve in patients aged less than 65 years and was better for the Carpentier-Edwards valve in patients aged more than 65 years. Patients with renal disease, lung disease (in patients more than age 60 years), ejection fraction less than 40%, or coronary disease had a life expectancy of less than 10 years. CONCLUSIONS: For first-time, isolated aortic valve replacement, mechanical prostheses should be considered in patients under age 65 years with a life expectancy of at least 10 years. Bioprostheses should be considered in patients over age 65 years or with lung disease (in patients over age 60 years), renal disease, coronary disease, ejection fraction less than 40%, or a life expectancy less than 10 years.

Duke Scholars

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

May 1999

Volume

117

Issue

5

Start / End Page

890 / 897

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Stroke Volume
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis Implantation
 

Citation

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Peterseim, D. S., Cen, Y. Y., Cheruvu, S., Landolfo, K., Bashore, T. M., Lowe, J. E., … Glower, D. D. (1999). Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients. J Thorac Cardiovasc Surg, 117(5), 890–897. https://doi.org/10.1016/S0022-5223(99)70368-5
Peterseim, D. S., Y. Y. Cen, S. Cheruvu, K. Landolfo, T. M. Bashore, J. E. Lowe, W. G. Wolfe, and D. D. Glower. “Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients.J Thorac Cardiovasc Surg 117, no. 5 (May 1999): 890–97. https://doi.org/10.1016/S0022-5223(99)70368-5.
Peterseim DS, Cen YY, Cheruvu S, Landolfo K, Bashore TM, Lowe JE, et al. Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients. J Thorac Cardiovasc Surg. 1999 May;117(5):890–7.
Peterseim, D. S., et al. “Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients.J Thorac Cardiovasc Surg, vol. 117, no. 5, May 1999, pp. 890–97. Pubmed, doi:10.1016/S0022-5223(99)70368-5.
Peterseim DS, Cen YY, Cheruvu S, Landolfo K, Bashore TM, Lowe JE, Wolfe WG, Glower DD. Long-term outcome after biologic versus mechanical aortic valve replacement in 841 patients. J Thorac Cardiovasc Surg. 1999 May;117(5):890–897.
Journal cover image

Published In

J Thorac Cardiovasc Surg

DOI

ISSN

0022-5223

Publication Date

May 1999

Volume

117

Issue

5

Start / End Page

890 / 897

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Stroke Volume
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis Implantation