Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
Valvular Heart Disease
Comparison of the Long-Term Outcomes of Mechanical and Bioprosthetic Aortic Valves ― A Propensity Score Analysis ―
Kenji MinakataShiro TanakaNobushige TamuraShigeki YanagiYohei OhkawaShuichi OkonogiTatsuo KanekoAkihiko UsuiTomonobu AbeMitsuomi ShimamotoYoshiharu TakaharaKazuo YamanakaHitoshi YakuRyuzo Sakata
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2017 Volume 81 Issue 8 Pages 1198-1206

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Abstract

Background:The aim of this study was to assess the long-term outcomes of aortic valve replacement (AVR) with either mechanical or bioprosthetic valves according to age at operation.

Methods and Results:A total of 1,002 patients (527 mechanical valves and 475 bioprosthetic valves) undergoing first-time AVR were categorized according to age at operation: group Y, age <60 years; group M, age 60–69 years; and group O, age ≥70 years). Outcomes were compared on propensity score analysis (adjusted for 28 variables). Hazard ratio (HR) was calculated using the Cox regression model with adjustment for propensity score with bioprosthetic valve as a reference (HR=1). There were no significant differences in overall mortality between mechanical and bioprosthetic valves for all age groups. Valve-related mortality was significantly higher for mechanical valves in group O (HR, 2.53; P=0.02). Reoperation rate was significantly lower for mechanical valves in group Y (HR, 0.16; P<0.01) and group M (no events for mechanical valves). Although the rate of thromboembolic events was higher in mechanical valves in group Y (no events for tissue valves) and group M (HR, 9.05; P=0.03), there were no significant differences in bleeding events between all age groups.

Conclusions:The type of prosthetic valve used in AVR does not significantly influence overall mortality.

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© 2017 THE JAPANESE CIRCULATION SOCIETY
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