Long Term Outcomes Following Freestyle Stentless Aortic Bioprosthesis Implantation: An Australian Experience

Sherrah, Andrew G.; Jeremy, Richmond W.; Puranik, Rajesh; Bannon, Paul G.; Hendel, P. Nicholas; Bayfield, Matthew S.; Wilson, Michael K.; Brady, Peter; Marshman, David; Mathur, Manu; Brereton, R. John L.; Edwards, James; Stuklis, Robert; Worthington, Michael; Vallely, Michael P.

doi:10.1016/j.hlc.2015.05.011

Cited by 5 publications

(1 citation statement)

References 35 publications

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“…The actuarial freedom from SVD is up to 97% at 10 years of follow-up (eTable 3 and eFigure 6 in the Supplement). The time to SVD in published literature ranged from 4.41 years to 8.2 years, as reported by 4 studies …”

Section: Resultsmentioning

confidence: 94%

Durability Data for Bioprosthetic Surgical Aortic Valve

et al. 2019

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IMPORTANCEAlthough several studies have reported data on surgical aortic valve durability, variability in study methodologies and definitions as well as inadequate follow-up make the interpretation of data from these studies difficult to interpret.OBJECTIVE To review available data on structural valve deterioration (SVD) of surgical bioprosthetic aortic valves by examining the published literature as well as data reported to the US Food and Drug Administration (FDA).EVIDENCE REVIEW A systematic review using Preferred Reporting Items for Systematic Review and Meta-Analysis reporting guidelines to obtain all available data from preexisting literature on the actuarial freedom from SVD and outcomes of SVD. Data were collected from database inception to November 2016. Additionally, data reported to the FDA were obtained. FINDINGS In total, 167 studies and 12 FDA reports including 101 650 patients and 17 different valve types were analyzed. There were 11 different definitions of SVD used in the studies. Core laboratory data were available for 11 studies. Mean follow-up ranged from less than 1 year to 14 years. Kaplan-Meier estimates were reported for up to 30 years of follow-up, with 0% to 37% of patients remaining at risk at maximum follow-up. Food and Drug Administration-reported data are similarly variable in duration (mean follow-up range, 1.2 to 7 years) and completeness of follow-up, with final follow-up of 0.1% to 95%. CONCLUSIONS AND RELEVANCEThere is considerable variability in reporting SVD of surgical aortic valves, with different definitions and inadequate long-term systematically collected core laboratory data. Rigorously collected long-term data with standardized definitions for surgical valves are needed to provide a benchmark for the durability of rapidly evolving transcatheter valves.

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Section: Resultsmentioning

confidence: 94%

Durability Data for Bioprosthetic Surgical Aortic Valve

et al. 2019

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Morphometrical and biomechanical analyses of a stentless bioprosthetic valve: an implication to avoid potential primary tissue failure

Takaya

Masuda

Naganuma

et al. 2018

Gen Thorac Cardiovasc Surg

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Based on the morphometrical and biomechanical analyses of the stentless bioprosthesis, we demonstrated that there are differences in wall thickness and elasticity between each sinus of Valsalva. These differences suggest that the non-coronary sinus of Valsalva is the most vulnerable and at greater risk of tissue failure. The exclusion of the non-coronary sinus of Valsalva may be beneficial to mitigate the long-term risks of tissue failure in the stentless bioprosthesis.

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Influence of Age on Longevity of a Stentless Aortic Valve

Yang

Malik

Farhat

et al. 2020

The Annals of Thoracic Surgery

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Background. The longevity of a stentless valve in a younger population (20-60 years old) is unknown.Methods. From 1992 to 2015, 1947 patients underwent aortic valve/root replacement for aortic stenosis, insufficiency, root aneurysm, or aortic dissection with stentless bioprostheses (median size, 26 mm). At operation 105 patients were <40 years old, 528 were 40 to 59, 860 were 60 to 74, and 454 were ‡75 years. The data were obtained through chart review, administered surveys, and the National Death Index.Results. The 30-day mortality rate was 2.6%. During follow-up 807 patients (41%) died before reoperation, 993 (51%) were alive without reoperations because of deterioration, and 113 patients (5.8%) underwent reoperation for structural valve deterioration. After adjusting death and reoperation for non-structural valve deterioration causes as competing risks, the cumulative incidence of reoperation was significantly different between the younger groups (<40, 40-59) and the older groups (60-74, ‡75; P < .0001) but not inside the younger (<40 vs 40-59) or older (60-74 vs ‡75) group. The significant hazard ratio of reoperation for <40 versus ‡75 years of age was 12, <40 versus 60 to 74 was 4, 40 to 59 versus 60 to 74 was 3, and 40 to 59 versus ‡75 was 9 (P £ .01). The 10-and 15-year survival in the entire cohort was 53% and 29%, respectively.Conclusions. The stentless aortic valve provides satisfactory durability as a conduit for aortic valve/root replacement for patients who prefer a bioprosthesis. However it should be judiciously considered for patients younger than 60 years because of an increased incidence of reoperation for structural valve deterioration.

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Long Term Outcomes Following Freestyle Stentless Aortic Bioprosthesis Implantation: An Australian Experience

Cited by 5 publications

References 35 publications

Durability Data for Bioprosthetic Surgical Aortic Valve

Durability Data for Bioprosthetic Surgical Aortic Valve

Morphometrical and biomechanical analyses of a stentless bioprosthetic valve: an implication to avoid potential primary tissue failure

Influence of Age on Longevity of a Stentless Aortic Valve

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