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Long-term follow-up of bioprosthetic aortic valve replacement in patients aged ≤60 years
| Content Provider | Scilit |
|---|---|
| Author | Anselmi, Amedeo Flecher, Erwan Chabanne, Celine Ruggieri, Vito Giovanni Langanay, Thierry Corbineau, Hervé Leguerrier, Alain Verhoye, Jean-Philippe |
| Copyright Year | 2017 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery To address the long-term durability of bioprostheses used for aortic valve replacement (AVR) in adult patients aged ≤60 years at the time of surgery.Through a retrospective review of a prospectively collected database, we identified 416 bioprosthetic AVRs performed between 1977 and 2013. A prospective follow-up of valve-related and non-valve-related events was performed.Follow-up was 98.5% complete (2423.1 patient-years; average, 6 ± 5.5 years). At 15 years, overall survival was 62.1 ± 4.4%; freedom from valve-related death was 97.1 ± 1.6%. There were 68 SVD events (11.9 ± 28.8 years after surgery). Freedom from SVD at 15 years was 48.7 ± 5.5% for Kaplan-Meier analysis and 61.4 ± 4.3% for competing-risks analysis. After stratification into age subgroups (<40 years, ≥40 and <50 years, and ≥50 and ≤60 years), we observed no significant difference in freedom from SVD (P = .50). The average delay to SVD was not statistically different among subgroups (P = .30). There were 57 reoperations for SVD (11.8 ± 5.2 years after implantation). The 15 year freedom from reoperation for SVD was 55.4 ± 5.6% by Kaplan-Meier analysis and 67.1 ± 4.2% by competing-risks analysis. After stratification by age, freedom from reoperation for SVD was comparable (P = .13). Freedom from any valve-related complication or death was 42 ± 5% by Kaplan-Meier analysis and 54.4 ± 4.1% by competing-risks analysis.The lifetime risk of SVD is considerable in patients aged ≤60 years at the time of bioprosthesis implantation. Nonetheless, durability remains consistent during the first decade; additional data are required for the second decade. Patients' information is pivotal for valve choice (competing-risks method). |
| Related Links | http://www.jtcvs.org/article/S002252231731187X/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2017.05.103 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 5 |
| Volume Number | 154 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2017-11-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Aortic Valve Replacement |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
