Early and long‐term outcome of aortic valve replacement with homograft versus mechanical prosthesis—8‐year follow‐up study

Abstract

SummaryBnckgroutzd: Aortic valve disease is an important and frequent clinical problem with a mortality rate as high as 50230% in a 5-year natural history of patients with severe aortic valve disease. Biological or mechanical prosthesis implantation is the only way to improve prognosis.Hypothesis: The aim of our study WiiS to assess the clinical outcome of aortic valve replacement according to the underlying valve pathology and the type of replacement device, that is, aortic homografts versus mechanical prostheses.Metlzods: The study group consisted of 143 patients with a mean follow-up period of 4.1 k 2.7 years. All patients had annual clinical and Doppler echocardiographic evaluation.Results: Total 8-year mortality was 4..9% (7/143) including early mortality of 1.4%. Eight-year survival probability was not significantly higher in the homograft than in the mechanical prosthesis recipients. No differences were found among subgroups with aortic stenosis, insufficiency, and combined disease. Overall early and late complication rate (13.3 and 24.8%, respectively) was similar in homograft and mechanical valve recipients. The most common late complications were ventricular arrhythmia (10%) (L,own class I-III), pre-

Long-Term Survival and Valve-Related Complications in Young Women With Cardiac Valve Replacements

“…14 There is limited informa-tion on the survival and valve complications of young women with homografts and no information on the effect of pregnancy on valve survival. 15,16 In this study, we investigated which type of valve replacement (mechanical, bioprosthetic, or homograft) was associated with the greatest long-term survival in young women and compared the rate of valve complications with each valve type. We also investigated whether pregnancy was associated with increased or earlier valve loss.…”

Predictors of mortality after aortic valve replacement

“…Currently, AVR accounts for 13% of all adult cardiac surgery [2], and remains the most common procedure among all cardiac valve operations in the United States [3]. The 5-year mortality of aortic valve disease without surgery is estimated to range from 50% to 80% [4]. After surgery, patients with severe aortic valve disease show dramatic improvement in their cardiovascular symptoms and survival [5,6].…”

Search for the best heart valve- from replacement to repair

“…Midterm follow up at 8 years revealed freedom from valve failure of 92%. Dziatkowiak et al [17] in 1997 published good results with aortic root replacement in 43 patients using antibiotic sterilized "fresh" unstented homograft (modification of annulus reinforcement) in repair of aortic aneurysm of ascending aorta. Ross JK et al [18] published in 1986 their results with aortic valve replacement with antibiotic sterilized homograft valves: At 11 year follow-up, freedom from re-operation was 90%.…”