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Clinical outcomes and hospital readmission rates in mechanical vs bioprosthetic mitral valves
Author(s) -
Sultan Ibrahim,
Bianco Valentino,
Gleason Thomas G.,
ArandaMichel Edgar,
Navid Forozan,
Kilic Arman
Publication year - 2019
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.14073
Subject(s) - medicine , propensity score matching , mitral valve replacement , mechanical valve , mortality rate , single center , retrospective cohort study , mitral valve , surgery , cohort , significant difference , cardiology
Abstract Objective Recent national trends have demonstrated increased use of bioprosthetic mitral valves. The primary objective of this study was to compare clinical outcomes as well as readmission rates for mechanical vs bioprosthetic mitral valve replacement (mMVR vs bMVR). Methods All patients undergoing MVR from 2011‐2017 were included in a single center data set that was obtained retrospectively from a prospectively maintained cardiac surgical database. Results The total MVR patient cohort consisted of 828 patients, including bMVR (n = 522) and mMVR (n = 306). There was no significant difference in the operative (30‐day) mortality between bMVR and mMVR (8.6% vs 6.5%; P = .31). The unadjusted estimated 1‐year mortality was significantly higher for the bMVR group (19.8% vs 13.7%, P = .04) and this trend continued for the estimated 5‐year mortality (35.1% vs 18.7%; P = .001). Valve prosthesis choice (bMVR vs mMVR) did not have a risk‐adjusted impact on operative mortality at 30 days ( P = .58); however 1‐year ( P = .05) and 5‐year ( P = .05) mortality remained significantly higher for the bMVR group. Propensity matching revealed a higher mortality rate on follow‐up in the bMVR (26.7% vs 18.2%, P = .03) but no difference at 30 days or 1 year. There was no difference in hospital readmissions over 5 years Conclusions Mechanical prostheses may confer a survival benefit in patients undergoing MVR. With emphasis on patient education and anticoagulation compliance, mMVR remains an efficacious option.