Comparable long-term results for porcine and pericardial prostheses after isolated aortic valve replacement

作者：Andreas Martin^*; Wallner Stephanie; Ruetzler Kurt; Wiedemann Dominik; Ehrlich Marek; Heinze Georg; Binder Thomas; Moritz Anton; Hiesmayr Michael J; Kocher Alfred; Laufer Guenther

来源：European Journal of Cardio-Thoracic Surgery, 2015, 48(4): 557-561.

DOI：10.1093/ejcts/ezu466

• Aortic valve replacement
• Biological heart valves
• Bioprosthesis
• Survival analysis

Outcome of aortic valve replacement may be influenced by the choice of bioprosthesis. Pericardial heart valves are described to have a favourable haemodynamic profile compared with porcine valves, although the clinical notability of this finding is still controversially debated. Herein, we compared the long-term results of two commonly implanted bioprosthesis at a single centre.
All consecutive patients undergoing isolated aortic valve replacement with either a Carpentier-Edwards Magna pericardial prosthesis or a Medtronic Mosaic porcine prosthesis between 2002 and 2008 were analysed regarding preoperative characteristics, short- and long-term survival, valve-related complications and echocardiographic findings.
The Medtronic Mosaic was implanted in 163 patients and the Carpentier-Edwards Magna in 295 patients. The sizes of implanted valves were 22.4 +/- 1.5 mm for the Mosaic and 21.8 +/- 1.8 mm for the Magna (P = 0.001). The long-term survival rate was 76 and 56% after 5 and 10 years for the Medtronic Mosaic, which was comparable with the Carpentier-Edwards Magna (77 and 57%; P = 0.92). Overall long-term survival was comparable with an age- and sex-matched Austrian general population for both groups. Valve-related adverse events were similar between groups. The postoperative mean transvalvular gradient was significantly increased in the Mosaic group (24 +/- 9 mmHg vs 17 +/- 7 mmHg; P < 0.001).
Both types of aortic bioprostheses offer excellent results after isolated aortic valve replacement. Despite relevant differences in gradients, long-term survival was comparable with the expected normal survival for both bioprostheses. Patients with a porcine heart valve had a higher postoperative transvalvular gradient.

• 出版日期2015-10