Annals of Thoracic and Cardiovascular Surgery
Online ISSN : 2186-1005
Print ISSN : 1341-1098
ISSN-L : 1341-1098
Original Articles
Choice of Aortic Valve Prosthesis in a Rapidly Aging and Long-Living Society
Yoshimasa SakamotoMichio YoshitakeYoko MatsumuraHitomi NaruseKo BandoKazuhiro Hashimoto
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2016 Volume 22 Issue 6 Pages 333-339

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Abstract

Purpose: The aim of this study was to evaluate the long-term results of aortic valve replacement (AVR) with mechanical (M) and bioprosthetic (B) valves as recommended by the Japanese guidelines.

Methods: From April 1995 to March 2014, 366 adult patients underwent AVR. Of these, 127 (35%) patients received M and 239 patients (65%) received B valves. A retrospective analysis of the entire and the selected 124 patients aged 60 to 70 years was carried out.

Results: In patients aged 60 to 70 years, the 15-year survival and freedom from reoperation were 88% ± 7% and 100% for the M group and 34% ± 25% (p <0.001) and 73% ± 14% (p = 0.059) for the B group, respectively. Among propensity score matching of the subgroup, there was no significant difference in survival and freedom from reoperation. The rate of thromboembolism was higher in the M (M: 0.58% vs B: 0.35% patient per year, p <0.001) and the rate of hemorrhage was higher in the M group (M: 0.34% vs B: 0.12% patient per year, p <0.001).

Conclusion: The current strategy of aortic valve choice based on the Japanese guidelines has provided excellent long-term results so far.

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© 2016 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery

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