Early Postoperative Bioprosthetic Valve Calcification

Iyer, Anand; Malik, Paras; Prabha, Ramesh Damodaran; Kugathasan, Gana; Kuteyi, Opeyemi; Marney, Lucy; Larbalestier, Robert

doi:10.1016/j.hlc.2012.12.016

Cited by 8 publications

(7 citation statements)

References 4 publications

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“…The American College of Cardiology/American Heart Association treatment guidelines published in 1998 recommended mechanical valves for patients on hemodialysis because it had been reported that bioprosthetic valves in such patients tended to develop SVD in the early postoperative period. [5][6][7] However, other studies found that patients on hemodialysis undergoing AVR have limited life expectancy and their bioprosthetic valves did not survive long enough to experience significant SVD requiring reoperation. [8][9][10][11][12][13][14] Accordingly, the recommendation of mechanical valves in patients on hemodialysis was removed from the revised American College of Cardiology/American Heart Association guidelines in 2006.…”

Section: Perspectivementioning

confidence: 99%

Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis

Nakatsu

Minakata

Tanaka

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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Objective: To investigate the influence of choice of prosthesis (bioprosthetic valves or mechanical valves) on intermediate-term outcomes in patients on hemodialysis undergoing aortic valve replacement (AVR).Methods: A multi-institutional retrospective cohort study was conducted in 18 Japanese centers. All adult patients on chronic hemodialysis who underwent AVR from 2008 and 2015 were included (n ¼ 491). The early and late results were compared between groups. The hazard ratios were calculated using Cox regression and Fine-Gray models with adjustment for propensity score based on 41 confounders. The mean follow-up period was 2.5 AE 2.1 years (up to 8.3 years) with 98% completeness.Results: There were 323 patients who received a bioprosthetic valve (group B), and 168 patients who received a mechanical valve (group M). There was no significant difference for in-hospital death rate between groups (group B: 12.1%; group M: 8.9%; P ¼ .29). The overall survival rate at 5 years after surgery was 39.3% in group B and 50.4% in group M (P ¼ .42). Freedom from reoperation at 5 years was 97.1% in group B and 97.8% in group M (P ¼ .88). On propensity-score adjusted analyses, there were no significant differences in overall survival between groups.Conclusions: There were no significant differences in overall survival between bioprosthetic valves and mechanical valves in patients on hemodialysis undergoing AVR.

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Section: Perspectivementioning

confidence: 99%

Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis

Nakatsu

Minakata

Tanaka

et al. 2019

The Journal of Thoracic and Cardiovascular Surgery

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“…Clearly, congenital heart valve disease in pediatric patients is an issue [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]. For example left and right heart failure resulting from pulmonary and aortic stenosis and ventricular dysfunction post pulmonary valve regurgitation in conditions such as tetralogy of Fallot [16][17][18][19][20][21][22].…”

Section: Resultsmentioning

confidence: 99%

“…Postoperative calcification which leads to valve degeneration is also a major issue for bioprosthetic heart valves. Glutaraldehyde fixation spurs cell devitalisation and facilitates the reaction of calciumcontaining extracellular fluid with membrane-associated phosphorus to produce calcium phosphate mineral deposits [12][13]. Young recipient age, along with other factors such as mechanical stress is thought to enhance the calcification process [12][13].…”

Section: Introductionmentioning

confidence: 99%

Bone marrow mesenchymal stem cells for tissue engineered pulmonary valves (TEPV)

Asumda¹,

Lamin²

2014

J Regen Med Tissue Eng

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Heart valve tissue engineering and regeneration represents a novel, and viable alternative treatment modality for valvular heart disease. Tissue-engineered pulmonary valves (TEPV) have been constructed from autologous cells grown on 3D biodegradable scaffolds or decelluarized xeno-or homografts and surgically implanted in animal models. From a translational stand point, constructed valves must maintain regenerative competency in recipients, with minimum risk for stenosis over the long term. Stem cells are an attractive cell source for this proposed solution; candidate cells are expected to maintain robust differentiation and transdifferentiation capacity. Transplanted cells must persist, engraft, and couple electro-mechanically with endogenous tissue. Here, we present a discussion on the clinical applicability of bone marrow mesenchymal stem cells in TEPV.

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“…One patient with dialysis underwent surgical aortic valve replacement due to the recurrence of significant aortic stenosis of the second TAV in ≤1 year, which is compatible with reports indicating that chronic renal failure is a risk factor for SVD. 26,27 Renal failure can accelerate the progression of TAV degeneration, similar to the native aortic valve, mainly due to reactive hyperparathyroidism and resultant hypercalcemia. 28,29 This emphasizes the importance of carrying out a large study with a long-term follow-up on the efficacy of TAVI in dialysis patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Redo Transcatheter Aortic Valve Implantation for Structural Valve Degeneration of Transcatheter Aortic Valve

et al. 2019

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Background: The outcome of redo transcatheter aortic valve (TAV) implantation (TAVI) is unknown for TAV structural valve degeneration (SVD). This paper reports the initial results of redo TAVI for TAV-SVD in Japanese patients. Methods and Results: Of 630 consecutive patients, 6 (1.0%) underwent redo TAVI for TAV-SVD (689-1,932 days after the first TAVI). The first TAV were 23-mm balloon-expandable valves (BEV, n=5) and a 26-mm self-expandable valve (SEV, n=1). All patients underwent multidetector computed tomography (MDCT) before redo TAVI, which showed first-TAV under-expansion (range, 19.1-21.0 mm) compared with the label size. Two BEV and 4 SEV were successfully implanted as second TAV, without moderate/severe regurgitation or 30-day mortality. One of 2 patients with a BEV-inside-BEV implantation had a high transvalvular mean pressure gradient post-procedurally (34 mmHg) and required surgical valve replacement 248 days after the redo TAVI. This, however, was unnoted in patients with SEV implantation during redo TAVI. Planned coronary artery bypass grafting was concomitantly performed in 1 patient with a small sino-tubular junction and SEV-inside-SEV implantation because of the risk of coronary malperfusion caused by the first TAV leaflets. Five of the 6 patients survived during the follow-up period (range, 285-1,503 days). Conclusions: Redo TAVI for TAV-SVD appears safe and feasible, while specific strategies based on MDCT and device selection seem important for better outcomes.

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Early Postoperative Bioprosthetic Valve Calcification

Cited by 8 publications

References 4 publications

Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis

Intermediate-term outcomes of aortic valve replacement with bioprosthetic or mechanical valves in patients on hemodialysis

Bone marrow mesenchymal stem cells for tissue engineered pulmonary valves (TEPV)

Outcomes of Redo Transcatheter Aortic Valve Implantation for Structural Valve Degeneration of Transcatheter Aortic Valve

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