Ferdinand Vogt1,2, Giuseppe Santarpino1,3,4, Buntaro Fujita5, Christian Frerker6,7, Timm Bauer8, Andreas Beckmann9,10, Raffi Bekeredjian11, Sabine Bleiziffer12, Helge Möllmann13, Thomas Walther7,14, Friedhelm Beyersdorf15, Christian Hamm7,16, Andreas Böning17, Stephan Baldus18, Stephan Ensminger5,7, Theodor Fischlein1, Dennis Eckner19. 1. Department of Cardiac Surgery, Paracelsus Medical University, Nuremberg, Germany. 2. Department of Cardiac Surgery, Artemed Clinic Munich South, Munich, Germany. 3. Cardiac Surgery Unit, Department of Experimental and Clinical Science, Magna Graecia University of Catanzaro, Catanzaro, Italy. 4. Department of Cardiac Surgery, Anthea Hospital, GVM Care & Research, Bari, Italy. 5. Department of Thoracic and Cardiovascular Surgery, University Hospital, Lübeck, Germany. 6. Department of Cardiology, University Hospital, Heart Center, Lübeck, Germany. 7. Department of Cardiac Surgery, DZHK (German Centre for Cardiovascular Research). 8. Department of Cardiology, Sana Klinikum Offenbach, Germany. 9. German Society of Thoracic, Cardiac and Vascular Surgery (Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, DGTHG), Berlin, Germany. 10. Department of Cardiac Surgery, Heart Centre Duisburg, Evangelisches Krankenhaus Niederrhein, Duisburg, Germany. 11. Department of Cardiology, University of Heidelberg, Heidelberg, Germany. 12. Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany. 13. Department of Internal Medicine I, St.-Johannes-Hospital, Dortmund, Germany. 14. Department of Cardiac, Thoracic and Thoracic Vascular Surgery, University Hospital Frankfurt, Frankfurt, Germany. 15. Department of Cardiovascular Surgery, Heart Centre Freiburg University, Freiburg, Germany. 16. Department of Cardiac Surgery, Kerckhoff Heart and Thorax Center, Bad Nauheim, Kerckhoff Campus of Justus-Liebig University, Giessen, Germany. 17. Department of Cardiothoracic Surgery, University Hospital Giessen, Giessen, Germany. 18. Department of Internal Medicine III, University Hospital of Cologne, Cologne, Germany. 19. Department of Cardiology, Paracelsus Medical University, Nuremberg, Germany.
Abstract
OBJECTIVES: The aim of this study was to analyse the outcome of patients between 50 and 69 years of age undergoing biological or mechanical aortic valve replacement. METHODS: Data were collected from the German Aortic Valve Registry. Data were analysed regarding baseline characteristics and outcome parameters such as 5-year survival, stroke and reintervention. RESULTS: In total. 3046 patients undergoing isolated surgical aortic valve replacement between 2011 and 2012 were investigated and a propensity score matching was performed. Within this period, 2239 patients received a biological prostheses, while 807 patients received a mechanical prosthesis. Mean age in the biological group was 63.07 (±5.11) and 57.34 (±4.67) in the mechanical group (standardized mean difference 1.172). In the overall cohort, there were more female patients in the biological group (32.7% vs 28.4%) and log EuroSCORE I was higher (5.41% vs 4.26%). After propensity matching (610 pairs), there was no difference in the mortality at 5-year follow-up (12.1% biological vs 9.2% mechanical P = 0.05) nor for reoperation/reintervention (2.5% biological vs 2.0% mechanical, P = 0.546). Patients undergoing mechanical aortic valve replacement suffered from a higher stroke rate 3.3% vs 1.5% (P = 0.04) at 5-year follow-up. CONCLUSIONS: Aortic valve replacement with biological or mechanical prostheses showed similar 5-year outcomes for survival and reoperation in a propensity-matched cohort, but significantly increased stroke rate after mechanical aortic valve replacement. This could influence the choice of a mechanical valve in younger patients.
OBJECTIVES: The aim of this study was to analyse the outcome of patients between 50 and 69 years of age undergoing biological or mechanical aortic valve replacement. METHODS: Data were collected from the German Aortic Valve Registry. Data were analysed regarding baseline characteristics and outcome parameters such as 5-year survival, stroke and reintervention. RESULTS: In total. 3046 patients undergoing isolated surgical aortic valve replacement between 2011 and 2012 were investigated and a propensity score matching was performed. Within this period, 2239 patients received a biological prostheses, while 807 patients received a mechanical prosthesis. Mean age in the biological group was 63.07 (±5.11) and 57.34 (±4.67) in the mechanical group (standardized mean difference 1.172). In the overall cohort, there were more female patients in the biological group (32.7% vs 28.4%) and log EuroSCORE I was higher (5.41% vs 4.26%). After propensity matching (610 pairs), there was no difference in the mortality at 5-year follow-up (12.1% biological vs 9.2% mechanical P = 0.05) nor for reoperation/reintervention (2.5% biological vs 2.0% mechanical, P = 0.546). Patients undergoing mechanical aortic valve replacement suffered from a higher stroke rate 3.3% vs 1.5% (P = 0.04) at 5-year follow-up. CONCLUSIONS: Aortic valve replacement with biological or mechanical prostheses showed similar 5-year outcomes for survival and reoperation in a propensity-matched cohort, but significantly increased stroke rate after mechanical aortic valve replacement. This could influence the choice of a mechanical valve in younger patients.