Document Detail


Aortic valve replacement: is porcine or bovine valve better?
MedLine Citation:
PMID:  23211215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: 'Is porcine or bovine valve better for aortic valve replacement?' Altogether, 562 papers were found using the reported search, of which 15 represented the best evidence to answer the question. All papers represent either level 1 or 2 evidence. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. This best evidence paper includes 9880 patients from 1974-2006 to compare both valve types. All studies compared either all or some of the following outcomes: complication, durability, mortality, functional status and haemodynamic function. Ten of 15 papers assessed the complication profile due to aortic valve replacement in both valve types. Four papers concluded that bovine valves are superior, whereas only one favoured porcine valves. Five papers showed a similar complication profile between both valves. Six of 15 papers commented on valve durability. Both porcine and bovine valve groups have two papers each to support their superiority in valve durability. Two papers demonstrated similar durability in both valves. There are 11 papers comparing the postoperative mortality. We suggest that there is no difference in mortality profile as eight papers showed that both valves had similar mortality profiles. Two papers supported bovine valve and one paper supported porcine valve in this aspect. There were four papers assessing the postoperative functional status, with three papers suggesting that both valve types had similar clinical improvement postoperatively. Eleven papers compared the haemodynamic function. Nine papers were in favour of bovine valves. Two papers demonstrated similar haemodynamic profiles in both valves. In conclusion, the bovine valve is superior in its complication and haemodynamic profiles. Both bovine and porcine valves have comparable results with regard to the mortality, postoperative functional status and valve durability. Significant variability between the valve manufacturers, study designs, study period and patient population in the above studies impose limitations to the comparison of both valves.
Authors:
Kok Hooi Yap; Ralph Murphy; Mohan Devbhandari; Rajamiyer Venkateswaran
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Publication Detail:
Type:  Journal Article; Review     Date:  2012-12-04
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  16     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-12     Completed Date:  2013-07-26     Revised Date:  2014-03-07    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  361-73     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Animals
Aortic Valve / physiopathology,  surgery*
Aortic Valve Stenosis / mortality,  physiopathology,  surgery*
Benchmarking
Bioprosthesis*
Cattle
Evidence-Based Medicine
Female
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation / adverse effects,  instrumentation*,  mortality
Hemodynamics
Humans
Male
Prosthesis Design
Prosthesis Failure
Swine
Time Factors
Treatment Outcome
Comments/Corrections
Comment In:
Interact Cardiovasc Thorac Surg. 2013 Mar;16(3):374   [PMID:  23400537 ]
Interact Cardiovasc Thorac Surg. 2013 Mar;16(3):373-4   [PMID:  23400536 ]

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