scholarly journals The impact of prosthesis–patient mismatch on long-term survival after aortic valve replacement: a systematic review and meta-analysis of 34 observational studies comprising 27 186 patients with 133 141 patient-years

2012 ◽  
Vol 33 (12) ◽  
pp. 1518-1529 ◽  
Author(s):  
Stuart J. Head ◽  
Mostafa M. Mokhles ◽  
Ruben L.J. Osnabrugge ◽  
Philippe Pibarot ◽  
Michael J. Mack ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Observational Studies ◽  
Meta Analysis ◽  
Term Survival ◽  
Long Term Survival ◽  
The Impact

scholarly journals The Prospects of Secondary Moderate Mitral Regurgitation after Aortic Valve Replacement —Meta-Analysis

2020 ◽  
Vol 17 (19) ◽  
pp. 7335
Author(s):  
Ilija Bilbija ◽  
Milos Matkovic ◽  
Marko Cubrilo ◽  
Nemanja Aleksic ◽  
Jelena Milin Lazovic ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Meta Analysis ◽  
Reverse Remodeling ◽  
Term Survival ◽  
Long Term Survival

Aortic valve replacement for aortic stenosis represents one of the most frequent surgical procedures on heart valves. These patients often have concomitant mitral regurgitation. To reveal whether the moderate mitral regurgitation will improve after aortic valve replacement alone, we performed a systematic review and meta-analysis. We identified 27 studies with 4452 patients that underwent aortic valve replacement for aortic stenosis and had co-existent mitral regurgitation. Primary end point was the impact of aortic valve replacement on the concomitant mitral regurgitation. Secondary end points were the analysis of the left ventricle reverse remodeling and long-term survival. Our results showed that there was significant improvement in mitral regurgitation postoperatively (RR, 1.65; 95% CI 1.36–2.00; p < 0.00001) with the average decrease of 0.46 (WMD; 95% CI 0.35–0.57; p < 0.00001). The effect is more pronounced in the elderly population. Perioperative mortality was higher (p < 0.0001) and long-term survival significantly worse (p < 0.00001) in patients that had moderate/severe mitral regurgitation preoperatively. We conclude that after aortic valve replacement alone there are fair chances but for only slight improvement in concomitant mitral regurgitation. The secondary moderate mitral regurgitation should be addressed at the time of aortic valve replacement. A more conservative approach should be followed for elderly and high-risk patients.

Impact of Patient-Prosthesis Mismatch following Aortic Valve Replacement on Long-Term Survival and Quality of Life

2018 ◽  
Vol 68 (02) ◽  
pp. 124-130 ◽  
Author(s):  
Grischa Hoffmann ◽  
Selam Abraham-Westphal ◽  
Tim Attmann ◽  
Derk Frank ◽  
Georg Lutter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Term Survival ◽  
Long Term Survival ◽  
Patient Prosthesis Mismatch ◽  
The Impact

Abstract Background The impact of patient-prosthesis mismatch (PPM) after aortic valve replacement (AVR) on long-term survival and quality of life (QoL) remains controversial. The objective of this study was to evaluate the impact of PPM on long-term survival and QoL in a large cohort of patients treated with isolated stented biological AVR in a single-center experience. Methods We analyzed data of 632 consecutive patients following isolated stented biological AVR between 2007 and 2012 at our institution. We evaluated the QoL (393 evaluable patients) using the Short Form 12-item Health Survey (SF-12) questionnaire via telephone call and the impact of PPM on long-term survival (533 evaluable patients) by Kaplan–Meier's estimate. Results Severe PPM (<0.65 cm2/m2) had a negative impact on physical component summary (PCS) score (SF-12) compared with patients with moderate or no PPM (p = 0.014), while the mental component summary (MCS) score (SF-12) was not affected by the degree of PPM (p = 0.133). Long-term survival was not different among the three different PPM groups investigated (p = 0.75). Conclusion Severity of PPM demonstrated no influence on long-term survival and MCS score (SF-12), but it was associated with a lower PCS score (SF-12) in patients with severe PPM.

Survival after Aortic Valve Replacement with Bovine or Porcine Valve Prostheses: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 67 (04) ◽  
pp. 282-290 ◽  
Author(s):  
Natalie Glaser ◽  
Veronica Jackson ◽  
Anders Franco-Cereceda ◽  
Ulrik Sartipy
Keyword(s):  
Systematic Review ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Meta Analysis ◽  
Surgical Aortic Valve Replacement ◽  
Term Survival ◽  
All Cause Mortality ◽  
Porcine Bioprosthesis

Background Bovine and porcine bioprostheses are commonly used for surgical aortic valve replacement. It is unknown if the long-term survival differs between the two valve types.We performed a systematic review and meta-analysis to compare survival in patients who underwent aortic valve replacement and received a bovine or a porcine prosthesis. Methods We performed a systematic search of Medline, Embase, Web of Science, and the Cochrane Library. Cohort studies that compared survival between patients who underwent aortic valve replacement and received either a bovine or a porcine bioprosthesis and that reported overall long-term survival with hazard ratio (HR) and 95% confidence interval (CI) were included. Two authors independently reviewed articles considered for inclusion, extracted the information from each study, and performed the quality assessment. We performed a meta-analysis using a random effects model to calculate the pooled HR (95% CI) for all-cause mortality. We did sensitivity analyses to assess the robustness of our findings. Results Seven studies published between 2010 and 2015 were included, and the combined study population was 49,190 patients. Of these, 32,235 (66%) received a bovine, and 16,955 (34%) received a porcine bioprosthesis. There was no significant difference in all-cause mortality between patients who received a bovine compared with a porcine bioprosthesis (pooled HR 1.00, 95% CI: 0.92–1.09). Heterogeneity between studies was moderate (55.8%, p = 0.04). Conclusions This systematic review and meta-analysis suggest no difference in survival between patients who received a bovine versus a porcine bioprosthesis after aortic valve replacement. Our study provides valuable evidence for the continuing use of both bovine and porcine bioprosthetic valves for surgical aortic valve replacement.

Determining Which Prosthetic to Use During Aortic Valve Replacement in Patients Aged Younger than 70 Years: A Systematic Review of the Literature

1969 ◽  
Vol 22 (2) ◽  
pp. E070-E081 ◽  
Author(s):  
Philip Borger ◽  
Eric J Charles ◽  
Eric D Smith ◽  
J Hunter Mehaffey ◽  
Robert B Hawkins ◽  
...  
Keyword(s):  
Systematic Review ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Mechanical Prosthesis ◽  
Term Survival ◽  
Younger Patients ◽  
Long Term Survival ◽  
Mechanical Prostheses

Background: The choice of bioprosthesis versus mechanical prosthesis in patients aged less than 70 years undergoing aortic valve replacement (AVR) remains controversial, with guidelines disparate in their recommendations. The objective of this study was to explore outcomes after AVR for various age ranges based on type of prosthesis. Methods: A systematic review was undertaken according to the Preferred Reporting Instructions for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using Medline (PubMed), Cochrane, Web of Science, Embase, and Scopus databases. Rates of long-term survival (primary outcome), reoperation, major bleeding, thromboembolism, stroke, structural valve deterioration, and endocarditis were compared between subjects receiving biologic and mechanical prostheses. Findings were grouped into patients aged <60 years, aged ≤65 years, and finally aged <70 years. Results: A total of 19 studies met inclusion criteria. Seven evaluated patients aged <60 years, 4 of which found mechanical prosthesis patients to have higher long-term survival, whereas the remaining studies found no difference. Eight additional studies included patients aged 65 years or younger, and 9 studies included patients aged <70 years. The former found no difference in survival between prosthesis groups, whereas the latter favored mechanical prostheses in 3 studies. Bleeding, thromboembolism, and stroke were more prevalent in patients with a mechanical prosthesis, whereas reoperation was more common in those receiving a bioprosthesis. Conclusions: Published literature does not preclude the use of bioprostheses for AVR in younger patients. As new valves are developed, the use of bioprosthetic aortic valves in younger patients will likely continue to expand. Clinical trials are needed to provide surgeons with more accurate guidelines.

scholarly journals Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lytfi Krasniqi ◽  
Mads P. Kronby ◽  
Lars P. S. Riber
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Significant Risk ◽  
Valve Prosthesis ◽  
Term Survival ◽  
Long Term Survival ◽  
All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

scholarly journals New-onset postoperative atrial fibrillation after aortic valve replacement: Effect on long-term survival

2017 ◽  
Vol 154 (2) ◽  
pp. 492-498 ◽  
Author(s):  
Ben M. Swinkels ◽  
Bas A. de Mol ◽  
Johannes C. Kelder ◽  
Freddy E. Vermeulen ◽  
Jurriën M. ten Berg
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Postoperative Atrial Fibrillation ◽  
Term Survival ◽  
Long Term Survival ◽  
New Onset

Abstract 3172: Impact of Prosthesis-Patient Mismatch on Long-Term Survival After Aortic Valve Replacement

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Dania Mohty ◽  
Jean G. Dumesnil ◽  
Najmeddine Echahidi ◽  
Patrick Mathieu ◽  
François Dagenais ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Operative Mortality ◽  
Independent Predictor ◽  
Term Survival ◽  
Time Of Operation ◽  
The Impact

Background: We recently reported that Prosthesis-Patient Mismatch (PPM) is an independent predictor of operative mortality in patients undergoing aortic valve replacement (AVR). The objective of this study was to evaluate the impact of PPM on late postoperative survival. Methods and Results: Between 1992 and 2005, 2653 patients (age: 68±10 years; 61% of males) underwent AVR in our institution. Patients who died at the time of operation or within 30 days were excluded from this study. The projected indexed effective orifice area (EOAi) was derived from the published normal in vivo EOA values for each model and size of prosthesis and PPM was classified as severe if the EOAi was ≤0.65 cm 2 /m 2 , moderate if it was > 0.65 cm 2 /m 2 and ≤ 0.85 cm 2 /m 2 , or not clinically significant if >0.85 cm 2 /m 2 . PPM was severe in 40 patients (2%), moderate in 797 (31%), and not significant in 1739 (67%). Patients with severe PPM had higher proportion of female gender (67% vs. 38%; P=0.0002) and hypertension (68% vs. 55%, p=0.02) and larger body surface (1.86±0.25 vs. 1.77±0.20, p=0.02). For patients with severe PPM, 5-year survival rate (74±8%) and 10-year survival rate (40±10%) were significantly (p=0.008) less than for patients with moderate PPM (5-yr: 81±2% and 10-yr: 57±3%) or no significant PPM (5-yr: 84±1% and 10-yr: 61±2%). On multivariate analysis after adjustment for other predictors of outcome, severe PPM was associated with increased overall mortality (Hazard ratio 1.38, [95% Confidence Interval 1.04 –1.75]; (p=0.02) Conclusion: In our previous study, we reported that severe PPM is a powerful risk factor for operative mortality. The results of the present study now suggest that severe PPM is also an independent predictor of long-term mortality. Hence, for the patients who are identified to be at risk of severe PPM at the time of operation, every effort should be made to implant a prosthesis with a larger EOA. Funded by: Canadian Institutes of Health Research

Sign in / Sign up

Export Citation Format

Share Document