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Early and Late Outcomes of Aortic Valve Replacement Using Bioprosthetic Versus Mechanical Valve in Elderly Patients: A Propensity Analysis
Author(s) -
Okamoto Yuki,
Yamamoto Kazuo,
Yoshii Shinpei
Publication year - 2016
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.12719
Subject(s) - medicine , propensity score matching , aortic valve replacement , mechanical valve , aortic valve , incidence (geometry) , prosthesis , cardiology , stroke (engine) , surgery , cardiac skeleton , cohort , mechanical engineering , physics , stenosis , optics , engineering
A BSTRACT Background and aim of the study There is still controversy on the use of mechanical valves to treat elderly patients with a small aortic annulus who require aortic valve replacement (AVR). We compared our results in elderly patients who underwent AVR with a bioprosthetic or mechanical valve. Propensity matching adjusted for baseline differences in this study. Methods Between January 2001 and July 2014, 277 patients aged ≥75 years old who underwent AVR were enrolled. Of 277 patients, 104 patients were selected using propensity score matching analysis. Out of this cohort, 52 patients underwent AVR with a bioprosthetic valve (B group) and the remainder AVR with a mechanical valve (M group). Results There were no significant differences between the B and M groups in 30 days mortality (1.9% vs. 5.8%, p = 0.618). The incidence of patient‐prosthesis mismatch (PPM) after AVR tended to be lower in the M group than in the B group. The overall survival rates in the B and M groups at eight years were 72.8% and 73.3%, respectively (p = 0.473). No significant differences between the two groups were observed in freedom from valve‐related death, cardiac events, bleeding events, or stroke events. Conclusions AVR in elderly patients achieved relatively good short‐term and long‐term outcomes, and the incidence rates of valve‐related complications after using a mechanical valve were low. In a selected population of elderly patients, a mechanical valve may be acceptable. doi: 10.1111/jocs.12719 (J Card Surg 2016;31:195–202)