| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2001;122:257-269
© 2001 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease (ACD) |
From the Divisions of Cardiothoracic Surgery,b Cardiology,a and Biostatistics,c Departments of Surgeryb and Medicine,a The Cedars-Sinai Medical Center Burns & Allen Research Institute, University of California at Los Angeles School of Medicine, Los Angeles, Calif, and the Division of Cardiothoracic Surgery, St John's Hospital,c Santa Monica, Calif.
Received for publication June 29, 1999. Revisions requested Sept 8, 1999; revisions received Jan 22, 2001. Accepted for publication Feb 19, 2001. Address for reprints: Steven S. Khan, MD, Division of Cardiothoracic Surgery, Cedars-Sinai School of Medicine, 8700 Beverly Blvd, Room 6215, Los Angeles, CA 90048 (E-mail: khan{at}cshs.org).
Abstract
Objective: We sought to compare outcomes with tissue and St Jude Medical mechanical valves over a 20-year period.
Methods: Valve-related events and overall survival were analyzed in 2533 patients 18 years of age or older undergoing initial aortic, mitral, or combined aortic and mitral (double) valve replacement with a tissue valve (Hancock, Carpentier-Edwards porcine, or Carpentier-Edwards pericardial) or a St Jude Medical mechanical valve. Total follow-up was 13,390 patient-years. There were 666 St Jude Medical aortic valve replacements, 723 tissue aortic valve replacements, 513 St Jude Medical mitral valve replacements, 402 tissue mitral valve replacements, 161 St Jude Medical double valve replacements, and 68 tissue double valve replacements. The mean age was 68 ± 13.3 years (St Jude Medical valve, 64.5 ± 12.9; tissue valve, 72.0 ± 12.6).
Results: There were no overall differences in survival between tissue and mechanical valves. Multivariable analysis indicated that the type of valve did not affect survival. Analysis by age less than 65 years or 65 years or older and presence or absence of coronary disease revealed similar long-term survival in all subgroups. The risk of hemorrhage was lower in patients receiving tissue aortic valve replacements but was not significantly different in patients receiving mitral valve or double valve replacements. Thromboembolism rates were similar for tissue and mechanical valve recipients. However, reoperation rates were significantly higher in patients receiving both aortic and mitral tissue valves. The reoperation hazard increased progressively with time both in patients receiving aortic and in those receiving mitral tissue valves. Overall valve complications were initially higher with mechanical aortic valves but not with mechanical mitral valves. However, valve complication rates later crossed over, with higher rates in tissue valve recipients after 7 years in patients undergoing mitral valve replacement and 10 years in those undergoing aortic valve replacement.
Conclusions: Tissue and mechanical valve recipients have similar survival over 20 years of follow-up. The primary tradeoff is an increased risk of hemorrhage in patients receiving mechanical aortic valve replacements and an increased risk of late reoperation in all patients receiving tissue valve replacements. The risk of tissue valve reoperation increases progressively with time.
This article has been cited by other articles:
|
|
 |
|
  C. A. Yankah, M. Pasic, M. Musci, J. Stein, C. Detschades, H. Siniawski, and R. Hetzer Aortic valve replacement with the Mitroflow pericardial bioprosthesis: Durability results up to 21 years J. Thorac. Cardiovasc. Surg., September 1, 2008; 136(3): 688 - 696. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Brown, H. V. Schaff, B. D. Lahr, C. J. Mullany, T. M. Sundt, J. A. Dearani, C. G. McGregor, and T. A. Orszulak Aortic valve replacement in patients aged 50 to 70 years: Improved outcome with mechanical versus biologic prostheses. J. Thorac. Cardiovasc. Surg., April 1, 2008; 135(4): 878 - 884. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Sughimoto, K. Nakano, A. Gomi, H. Nakatani, Y. Nakamura, and A. Sato Hancock Valve Deterioration in Tricuspid Position for Ebstein's Anomaly Asian Cardiovasc Thorac Ann, April 1, 2008; 16(2): 157 - 158. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Eitz, S. Schenk, D. Fritzsche, A. Bairaktaris, O. Wagner, H. Koertke, and R. Koerfer International Normalized Ratio Self-Management Lowers the Risk of Thromboembolic Events After Prosthetic Heart Valve Replacement Ann. Thorac. Surg., March 1, 2008; 85(3): 949 - 955. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A.C. Ennker, A. A. Albert, U. P. Rosendahl, I. C. Ennker, F. Dalladaku, and I. Florath Ten-Year Experience With Stentless Aortic Valves: Full-Root Versus Subcoronary Implantation Ann. Thorac. Surg., February 1, 2008; 85(2): 445 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. W. Emery, A. M. Emery, A. Knutsen, and G. V. Raikar Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis Card. Surg. Adult, January 1, 2008; 3(2008): 841 - 856. [Full Text]
|
|
|
|
|
|
T. Gudbjartsson, T. Absi, and S. Aranki Mitral Valve Replacement Card. Surg. Adult, January 1, 2008; 3(2008): 1031 - 1068. [Full Text]
|
|
|
|
 |
|
 J. L. Svennevig, M. Abdelnoor, and S. Nitter-Hauge Twenty-Five Year Experience With the Medtronic-Hall Valve Prosthesis in the Aortic Position: A Follow-Up Cohort Study of 816 Consecutive Patients Circulation, October 16, 2007; 116(16): 1795 - 1800. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Vicchio, A. Della Corte, M. De Feo, G. Santarpino, L. S. De Santo, G. Romano, G. Caianiello, M. Scardone, and M. Cotrufo Quality of Life After Implantation of Bileaflet Prostheses in Elderly Patients: An Anticoagulation Work Group Experience Ann. Thorac. Surg., August 1, 2007; 84(2): 459 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Ota, S. Taketani, S. Iwai, S. Miyagawa, M. Furuta, M. Hara, E. Uchimura, Y. Okita, and Y. Sawa Novel Method of Decellularization of Porcine Valves Using Polyethylene Glycol and Gamma Irradiation Ann. Thorac. Surg., April 1, 2007; 83(4): 1501 - 1507. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kulik, P. Bedard, B-K. Lam, F. D. Rubens, P. J. Hendry, R. G. Masters, T. G. Mesana, and M. Ruel Mechanical versus bioprosthetic valve replacement in middle-aged patients. Eur. J. Cardiothorac. Surg., September 1, 2006; 30(3): 485 - 491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Rizzoli, S. Mirone, P. Ius, E. Polesel, T. Bottio, L. Salvador, C. Zussa, G. Gerosa, and C. Valfre Fifteen-year results with the Hancock II valve: A multicenter experience. J. Thorac. Cardiovasc. Surg., September 1, 2006; 132(3): 602 - 609.e4. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sawaki, A. Usui, T. Abe, M. Yoshikawa, T. Akita, and Y. Ueda Late Mortality and Morbidity in Elderly Patients with Mechanical Heart Valves Asian Cardiovasc Thorac Ann, June 1, 2006; 14(3): 189 - 194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Chan, W.R.E. Jamieson, E. Germann, F. Chan, R.T. Miyagishima, L.H. Burr, M.T. Janusz, H. Ling, and G.J. Fradet Performance of bioprostheses and mechanical prostheses assessed by composites of valve-related complications to 15 years after aortic valve replacement J. Thorac. Cardiovasc. Surg., June 1, 2006; 131(6): 1267 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. W. Akins, A. D. Hilgenberg, G. J. Vlahakes, J. C. Madsen, T. E. MacGillivray, G. M. LaMuraglia, and R. P. Cambria Late Results of Combined Carotid and Coronary Surgery Using Actual Versus Actuarial Methodology Ann. Thorac. Surg., December 1, 2005; 80(6): 2091 - 2097. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I Florath, A Albert, U Rosendahl, T Alexander, I C Ennker, and J Ennker Mid term outcome and quality of life after aortic valve replacement in elderly people: mechanical versus stentless biological valves Heart, August 1, 2005; 91(8): 1023 - 1029. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Emery, C. C. Krogh, K. V. Arom, A. M. Emery, K. Benyo-Albrecht, L. D. Joyce, and D. M. Nicoloff The St. Jude Medical Cardiac Valve Prosthesis: A 25-Year Experience With Single Valve Replacement Ann. Thorac. Surg., March 1, 2005; 79(3): 776 - 782. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Ruel, A. Kulik, B. K. Lam, F. D. Rubens, P. J. Hendry, R. G. Masters, P. Bedard, and T. G. Mesana Long-term outcomes of valve replacement with modern prostheses in young adults Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 425 - 433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. D. Potter, T. M. Sundt III, K. J. Zehr, J. A. Dearani, R. C. Daly, C. J. Mullany, C. G.A. McGregor, F. J. Puga, H. V. Schaff, and T. A. Orszulak Operative risk of reoperative aortic valve replacement J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 94 - 103. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J P A Puvimanasinghe, J J M Takkenberg, M B Edwards, M J C Eijkemans, E W Steyerberg, L A van Herwerden, K M Taylor, G L Grunkemeier, J D F Habbema, and A J J C Bogers Comparison of outcomes after aortic valve replacement with a mechanical valve or a bioprosthesis using microsimulation Heart, October 1, 2004; 90(10): 1172 - 1178. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Minakata, H. V. Schaff, K. J. Zehr, J. A. Dearani, R. C. Daly, T. A. Orszulak, F. J. Puga, and G. K. Danielson Is repair of aortic valve regurgitation a safe alternative to valve replacement? J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 645 - 653. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Vink, R. A. Kraaijenhagen, B. A. Hutten, R. B. A. van den Brink, B. A. de Mol, H. R. Buller, and M. Levi The optimal intensity of vitamin k antagonists in patients with mechanical heart valves: A meta-analysis J. Am. Coll. Cardiol., December 17, 2003; 42(12): 2042 - 2048. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. S. Ikonomidis, J. M. Kratz, A. J. Crumbley III, M. R. Stroud, S. M. Bradley, R. M. Sade, and F. A. Crawford Jr Twenty-year experience with the St Jude Medical mechanical valve prosthesis J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2022 - 2031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Emery, C. A. Erickson, K. V. Arom, W. F. Northrup III, T. E. Kersten, T. J. Von Rueden, and D. M. Nicoloff Replacement of the aortic valve in patients under 50 years of age: long-term follow-up of the St. Jude medical prosthesis Ann. Thorac. Surg., June 1, 2003; 75(6): 1815 - 1819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. W. Emery, G. J. Van Nooten, and P. J. Tesar The initial experience with the ATS Medical mechanical cardiac valve prosthesis Ann. Thorac. Surg., February 1, 2003; 75(2): 444 - 452. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Grunkemeier and Y. Wu "Our complication rates are lower than theirs": Statistical critique of heart valve comparisons J. Thorac. Cardiovasc. Surg., February 1, 2003; 125(2): 290 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. D. Desai and G. T. Christakis Stented Mechanical/Bioprosthetic Aortic Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 825 - 856. [Full Text]
|
|
|
|
|
|
T. Gudbjartsson, S. Aranki, and L. H. Cohn Mechanical/Bioprosthetic Mitral Valve Replacement Card. Surg. Adult, January 1, 2003; 2(2003): 951 - 986. [Full Text]
|
|
|
|
|
|
C. W. Akins, A. D. Hilgenberg, G. J. Vlahakes, T. E. MacGillivray, D. F. Torchiana, and J. C. Madsen Results of bioprosthetic versus mechanical aortic valve replacement performed with concomitant coronary artery bypass grafting Ann. Thorac. Surg., October 1, 2002; 74(4): 1098 - 1106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Cebotari, H. Mertsching, K. Kallenbach, S. Kostin, O. Repin, A. Batrinac, C. Kleczka, A. Ciubotaru, and A. Haverich Construction of Autologous Human Heart Valves Based on an Acellular Allograft Matrix Circulation, September 24, 2002; 106(12_suppl_1): I-63 - I-68. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
