Long-Term Survival of Mitroflow and Perimount Aortic Valve Replacements

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiac Surgery Pub Date : 2024-11-01 DOI:10.1155/2024/6712990
Lytfi Krasniqi, Jordi Sanchez Dahl, Christian Greve Jensen, Poul Erik Mortensen, Axel Brandes, Oke Gerke, Emil Johannes Ravn, Viktor Poulsen, Lars Peter Schødt Riber
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Abstract

Objectives: The American College of Cardiology (ACC) guidelines recommend the same imaging frequency for all bioprosthetic valves, but some have demonstrated poor durability. We aimed to assess mortality differences between small (19–21 mm) and large (23–29 mm) in Mitroflow and Carpentier-Edwards Perimount aortic valves.

Methods: A retrospective observational study was conducted by all patients undergoing isolated surgical aortic valve replacement with Mitroflow or Perimount in Western Denmark between 1999 and 2014 and followed until January 2024. The primary endpoint was all-cause mortality. Secondary endpoints were cardiovascular mortality and sudden cardiac death. A propensity score-matched analysis was performed.

Results: A total of 1150 patients were analyzed, with 496 (43%) receiving Mitroflow valves and 654 (57%) receiving Perimount valves. In the Mitroflow group, 108 (22%) had a valve size of 19–21 mm, and 388 (78%) in the size range of 23–29 mm. In the Perimount group, the distribution was 99 (15%) and 555 (85%), respectively. The compromised survival of Mitroflow valves was attributed to the valve type, regardless of the valve sizes. Larger Mitroflow valves exhibited the same compromised late mortality as smaller valves, 66.7% vs 61.5%, respectively (p = 0.95). The same pattern of mortality was observed in the matched population, with Perimount demonstrating significant lower risk of mortality.

Conclusion: Mitroflow valves were associated with a poorer prognosis compared to Perimount valves. Additionally, larger Mitroflow valves were not associated with an improved prognosis compared to smaller valve sizes. EuroSCORE2 had a significant impact on patient survival.

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Mitroflow 和包膜主动脉瓣置换术的长期存活率
目的:美国心脏病学会(ACC)指南建议对所有生物人工瓣膜采用相同的成像频率,但有些瓣膜的耐用性较差。我们的目的是评估 Mitroflow 和 Carpentier-Edwards Perimount 主动脉瓣小瓣(19-21 毫米)和大瓣(23-29 毫米)的死亡率差异。 方法:对1999年至2014年期间在丹麦西部接受Mitroflow或Perimount孤立手术主动脉瓣置换术的所有患者进行回顾性观察研究,并随访至2024年1月。主要终点是全因死亡率。次要终点是心血管死亡率和心脏性猝死。进行了倾向评分匹配分析。 结果:共分析了1150名患者,其中496人(43%)接受了Mitroflow瓣膜,654人(57%)接受了Perimount瓣膜。在Mitroflow组中,108人(22%)的瓣膜尺寸为19-21毫米,388人(78%)的瓣膜尺寸为23-29毫米。在 Perimount 组中,瓣膜大小分布分别为 99 个(15%)和 555 个(85%)。无论瓣膜大小如何,Mitroflow瓣膜的存活率都会受到影响。较大的Mitroflow瓣膜的晚期死亡率与较小的瓣膜相同,分别为66.7%和61.5%(P = 0.95)。在匹配人群中也观察到了相同的死亡率模式,Perimount 的死亡率风险显著较低。 结论:与 Perimount 瓣膜相比,Mitroflow 瓣膜的预后较差。此外,与较小的瓣膜相比,较大的Mitroflow瓣膜与较好的预后无关。EuroSCORE2对患者的存活率有显著影响。
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来源期刊
CiteScore
2.90
自引率
12.50%
发文量
976
审稿时长
3-8 weeks
期刊介绍: Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.
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