Tissue Versus Mechanical Prostheses: Quality of Life in Octogenarians

Vicchio, Mariano; Corte, Alessandro Della; Santo, Luca Salvatore De; Feo, Marisa De; Caianiello, Giuseppe; Scardone, Michelangelo; Cotrufo, Maurizio

doi:10.1016/j.athoracsur.2007.12.039

Cited by 67 publications

(45 citation statements)

References 22 publications

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“…25 Despite the need for lifelong anticoagulation in patients who receive a mechanical prosthesis, some reports have indicated no significant differences in postoperative quality of life, survival, or incidence of complications between mechanical and biological valves. 26 The effect of PPM on prognosis and cardiac function remains controversial. Mohty et al indicated that PPM negatively influences long-term survival in specific patient groups such as those with low cardiac function or severe PPM.…”

Section: -6mentioning

confidence: 99%

Mid-Term Outcomes After Aortic Valve Replacement With the 17-mm St. Jude Medical Regent Valve

Okamura

Yamaguchi

Nagano

et al. 2012

Circ J

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Section: -6mentioning

confidence: 99%

Mid-Term Outcomes After Aortic Valve Replacement With the 17-mm St. Jude Medical Regent Valve

Okamura

Yamaguchi

Nagano

et al. 2012

Circ J

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“…6 Recent publications, however, have shown that older patients who receive mechanical prostheses have equivalent quality of life and excellent survival compared with patients who receive tissue valves. 4,7 In the present study, we evaluated outcomes of elderly patients (Ն70 years of age) after AVR and focused our analysis on the identification of patients with increased longevity and the potential impact of valve type on overall survival.…”

mentioning

confidence: 99%

Aortic Valve Replacement in the Elderly

et al. 2011

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Background-Few data exist on long-term outcomes of elderly patients after aortic valve replacement. We evaluated latest follow-up information for patients Ն70 years of age after aortic valve replacement. Methods and Results-Late overall survival of 2890 consecutive patients Ն70 years of age who underwent aortic valve replacement between January 1993 and December 2007 was reviewed retrospectively, analyzed, and stratified by preoperative and intraoperative variables. Observed 5-, 10-, and 15-year late postoperative survival was lower than generally expected (68%, 34%, and 8% versus 70%, 42%, and 20%, respectively; PϽ0.001). Independent predictors of late death included older age, renal failure, diabetes mellitus, stroke, myocardial infarction, immunosuppression, prior coronary artery bypass grafting, implanted pacemaker, lower ejection fraction, hypertension, and New York Heart Association class III or IV. After stratification by age-comorbidity risk score, 10-year survival for the lowest-risk group (nϭ946 [33%]) was similar to expected survival (55% versus 55%; Pϭ0.50), but for the highest-risk group (nϭ564 [20%]), survival was significantly lower than expected (9% versus 26%; PϽ0.001). For 229 pairs of propensity-matched patients with mechanical or biological prostheses, survival was not significantly different (67%, 40%, and 19% versus 71%, 45%, and 7% at 5, 10, and 15 years, respectively; Pϭ0.81). Structural deterioration of bioprostheses occurred in 64 patients (2.4%). Conclusions-Survival of elderly patients after aortic valve replacement is influenced by age and preoperative comorbidities; 33% at lowest risk had overall survival similar to that of an age-and sex-matched general population. There was no sufficient evidence that valve type affected survival. Structural deterioration of aortic bioprostheses was rare.

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“…Two recent studies from Italy assessed quality of life in elderly patients having mechanical or bioprosthetic aortic valve replacement. Both Vicchio et al 22 and de Vincentiis et al 23 demonstrated excellent quality of life scores in octogenarians after AVR overall, and there was no difference in scores between patients having mechanical or bioprosthetic valves. Interestingly, in both of these series, survival rates were higher in patients with mechanical prostheses The potential impact of prosthesis "noise" upon quality of life is difficult to quantify and perhaps consequently, has received less attention in decision-making algorithms to date.…”

Section: Observational Studiesmentioning

confidence: 99%