Comparison of the long-term outcomes of mechanical and bioprosthetic aortic valves: A propensity score analysis

Kenji Minakata, Shiro Tanaka, Nobushige Tamura, Shigeki Yanagi, Yohei Ohkawa, Shuichi Okonogi, Tatsuo Kaneko, Akihiko Usui, Tomonobu Abe, Mitsuomi Shimamoto, Yoshiharu Takahara, Kazuo Yamanaka, Hitoshi Yaku, Ryuzo Sakata

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Background: The aim of this study was to assess the long-term outcomes of aortic valve replacement (AVR) with either mechanical or bioprosthetic valves according to age at operation. Methods and Results: A total of 1,002 patients (527 mechanical valves and 475 bioprosthetic valves) undergoing first-time AVR were categorized according to age at operation: group Y, age <60 years; group M, age 60–69 years; and group O, age ≥70 years). Outcomes were compared on propensity score analysis (adjusted for 28 variables). Hazard ratio (HR) was calculated using the Cox regression model with adjustment for propensity score with bioprosthetic valve as a reference (HR=1). There were no significant differences in overall mortality between mechanical and bioprosthetic valves for all age groups. Valve-related mortality was significantly higher for mechanical valves in group O (HR, 2.53; P=0.02). Reoperation rate was significantly lower for mechanical valves in group Y (HR, 0.16; P<0.01) and group M (no events for mechanical valves). Although the rate of thromboembolic events was higher in mechanical valves in group Y (no events for tissue valves) and group M (HR, 9.05; P=0.03), there were no significant differences in bleeding events between all age groups. Conclusions: The type of prosthetic valve used in AVR does not significantly influence overall mortality.

Original languageEnglish
Pages (from-to)1198-1206
Number of pages9
JournalCirculation Journal
Volume81
Issue number8
DOIs
Publication statusPublished - 2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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