Document Detail


Preferability of bioprostheses for isolated aortic valve replacement--a comparative study between mechanical and bioprosthetic valves.
MedLine Citation:
PMID:  2355449     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Comparative long-term performance characteristics of mechanical valves and bioprosthetic valves were analyzed retrospectively among patients who had undergone isolated aortic valve replacement between 1968 and 1987. One hundred sixty-seven patients received either mechanical (n = 82) or bioprosthetic (n = 85) valves. The cumulative follow-up was 926 patient-years (mean 6.1 +/- 4.7 years, ranging from 0.5 to 20.2 years, 100% complete follow-up). Actuarial survival rate, including operative death, at 10 years was 74 +/- 7% for mechanical and 77 +/- 7% for bioprosthetic valve recipients. The rates of freedom from thromboembolism, structural valve failure, prosthetic valve endocarditis, and valve re-replacement at 10 years were 77 +/- 7%, 100%, 96 +/- 2% and 95 +/- 3% for mechanical, and 94 +/- 4%, 83 +/- 8% (p less than 0.05), 88 +/- 5% and 75 +/- 8% (p less than 0.05) for bioprosthetic valve recipients, respectively. Thromboembolism occurred more frequently in the mechanical valve recipients (p less than 0.01), and structural valve failure in the bioprostheses recipients (p less than 0.05). There was no mortality at the time of valve re-replacement. Most of the bioprosthesis recipients received no anticoagulation therapy beyond 3 months postoperatively. Cardiac medication in the late postoperative period was not required in 31.3% of bioprosthetic, and 3.2% of mechanical valve recipients (p less than 0.01). These results show that bioprosthesis in the aortic position exhibits a superb antithrombogenicity and may enable a drug-free state, though its limited durability requires reoperation.
Authors:
Y Kawachi; K Tokunaga
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  54     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1990 Feb 
Date Detail:
Created Date:  1990-07-25     Completed Date:  1990-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  137-45     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adult
Aortic Valve / surgery*
Bioprosthesis* / adverse effects
Endocarditis / etiology
Female
Follow-Up Studies
Heart Valve Prosthesis* / adverse effects,  mortality
Humans
Male
Middle Aged
Postoperative Care
Prosthesis Failure
Reoperation
Retrospective Studies
Thromboembolism / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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