Valve Replacement Surgery in End-Stage Renal Failure: Mechanical Prostheses Versus Bioprostheses

Chan, Vincent; Jamieson, W.R. Eric; Fleisher, Arlen G.; Denmark, David; Chan, Florence; Eva, Gudumac

doi:10.1016/j.athoracsur.2005.09.009

Cited by 60 publications

(69 citation statements)

References 11 publications

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“…More recently, it has been suggested that there is no convincing evidence for accelerated calcification as a major cause of bioprosthetic valve failure and resultant adverse morbidity and mortality (23). A number of recent studies have demonstrated equivalent survival rates between bioprosthetic and mechanical valves dialysis patients (20). Our meta-analysis also confirms with previous studies by demonstrating the same equivalence of mortality and survival rates among valve prosthesis choice (31).…”

Section: Discussionsupporting

confidence: 81%

“…There was no significant difference in mid-term survival between bioprosthesis and mechanical valves. Of the 14 included studies, two studies (16,20) demonstrated a survival advantage in favour of mechanical prostheses over bioprosthesis and the remaining 12 studies failed to demonstrate a survival advantage according to prosthesis type. There was a significant reduction in bleeding events comparing bioprosthesis with mechanical valves (5.2% vs. 6.4%).…”

Section: Discussionmentioning

confidence: 99%

“…After exclusion of duplicate or irrelevant references, 40 potentially relevant articles were retrieved. After application of inclusion and exclusion criteria, 16 relevant articles were included in the present systematic review and meta-analysis (7,(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). A total of 8,483 patients with ESRD were included for analysis, including 6,187 receiving bioprosthesis and 2,296 receiving mechanical valves.…”

Section: Literature Searchmentioning

confidence: 99%

See 2 more Smart Citations

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Phan

Tsai

Zhao

et al. 2016

Heart, Lung and Circulation

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Bioprosthetic versus Mechanical Prostheses for Valve Replacement in End-stage Renal Disease Patients: Systematic review and meta-analysis

Phan

Tsai

Zhao

et al. 2016

Heart, Lung and Circulation

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“…All these factors lead to a high cardiac mortality and morbidity and to a poor survival, with a 5-year mortality rate of approximately 65% [37,38]. If a patient suffers additionally from diabetes or coronary artery disease, the survival rate is even lower.…”

Section: Renal Insufficiencymentioning

confidence: 99%

Mechanical versus biological aortic valve replacement strategies

Reineke

Gisler

Englberger

et al. 2016

Expert Review of Cardiovascular Therapy

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Aortic valve replacement (AVR) is the most frequently performed procedure in valve surgery.The controversy about the optimal choice of the prosthetic valve is as old as the technique itself. Currently there is no perfect valve substitute available. The main challenge is to choose between mechanical and biological prosthetic valves. Biological valves include pericardial (bovine, porcine or equine) and native porcine bioprostheses designed in stented or stentless versions. Homografts and pulmonary autografts are reserved for special indications and will not be discussed in detail in this review. We will focus on the decision making between artificial biological and mechanical prostheses, respectively.The first part of this article reviews guideline recommendations concerning the choice of aortic prostheses in different clinical situations while the second part is focused on novel strategies in the treatment of patients with aortic valve pathology.Keywords: aortic valve replacement, biological valve prosthesis, mechanical valve prosthesis, oral anticoagulation, novel oral anticoagulants. Current EvidenceThe current guidelines of the European Society of Cardiology from 2012 [1] and of the American Heart Association from 2014 [2] uniformly recommend mechanical aortic valve replacement (AVR) in patients under 60 years of age and biologic AVR in patients over 70 years of age (Fig. 1). In patients between 60 and 70 years of age, recommendations are conflicting. The ESC-Guidelines recommend biologic prosthesis from the age of 65 years onwards, whereas the newer AHA/ACC guidelines only recommend biological valves starting with 70 years of age. Looking at the development of the guidelines over the last 20 years there is a shift away from a clear-cut age limit towards the patients wish and life-style considerations.Currently there is a trend towards more biological AVR, also in patients under 65 years of age, which is contrary to the progress of life expectancy of patients at this age.Justification for this approach is the option for a valve-in-valve procedure in the case of structural valve deterioration (SVD) which might become a routine bail out strategy. In addition, the last generation of pericardial tissue valves may have excellent long-term durability over 20 years. However, current studies also demonstrate a significant age-

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“…Chronic renal failure is a known major risk factor for bleeding in patients with anticoagulant therapy (Lanefeld, 1989). These patients have also a increased risk of endocarditis due to frequent vascular access and impaired immunity (Chan, 2006). The type of aortic valve chosen for these patients should be individualized to the age of the patient and expected long-term survival.…”

Section: Comorbiditiesmentioning

confidence: 99%