Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective
Objective: To examine long-term surgical aortic valve replacement (SAVR) outcomes for young (ie, younger than age 65 years) patients with bicuspid aortic valve and aortic stenosis (AS) with or without concomitant aneurysm. Background: There are few studies evaluating the early and late outcomes of S...
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Elsevier
2024-09-01
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| Series: | JTCVS Structural and Endovascular |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950605024000044 |
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| author | Christopher K. Mehta, MD Tom X. Liu, MD, MS Abigail S. Baldridge, DrPh Jane Kruse, BSN Jyothy Puthumana, MD Robert O. Bonow, MD Duc T. Pham, MD Douglas R. Johnston, MD S. Christopher Malaisrie, MD Patrick M. McCarthy, MD |
| author_facet | Christopher K. Mehta, MD Tom X. Liu, MD, MS Abigail S. Baldridge, DrPh Jane Kruse, BSN Jyothy Puthumana, MD Robert O. Bonow, MD Duc T. Pham, MD Douglas R. Johnston, MD S. Christopher Malaisrie, MD Patrick M. McCarthy, MD |
| author_sort | Christopher K. Mehta, MD |
| collection | DOAJ |
| description | Objective: To examine long-term surgical aortic valve replacement (SAVR) outcomes for young (ie, younger than age 65 years) patients with bicuspid aortic valve and aortic stenosis (AS) with or without concomitant aneurysm. Background: There are few studies evaluating the early and late outcomes of SAVR in young patients (younger than age 65 years) with bicuspid aortic valve and AS. Methods: Using institutional data from 2004 through 2022, 498 patients with bicuspid aortic valve younger than age 65 years underwent SAVR for AS with bioprosthetic valves. We examined operative outcomes, long-term valve durability, and reintervention. Results: The total cohort comprised 281 patients undergoing isolated SAVR and 217 with concomitant aneurysm repair (SAVR/aneurysm). The average age was 55 ± 8 years, with Society of Thoracic Surgeons predicted risk of mortality score of median 0.7 (IQR 0.5, 1.0) and mean valve size of 25 mm. Operative mortality (0.7% vs 1.4%; P = .77) was similar between SAVR and SAVR/aneurysm patients. Predischarge permanent pacemaker implantation occurred in 1.6% (8 out of 498) patients. During overall follow-up of 5.0 years (IQR 1.8-9.9; range, 0.2-18.2 years), the cumulative incidence of reintervention at 10 years for structural valve degeneration (n = 33), including valve-in-valve (n = 15) was 6.6% (8.1% SAVR vs 4.5% SAVR/aneurysm; P = .66). No mortality was observed for valve-in-valve or redo-SAVR. Moderate or greater aortic regurgitation and paravalvular leak were observed in 6.5% and 0.3%, respectively, at most recent follow-up. Conclusions: Bicuspid AS is common in patients younger than 65 years and management includes consideration of future valve intervention. SAVR confers excellent operative and reoperative outcomes, 10-year durability, and valve function. These results may support initial SAVR when considering lifetime management of AS. |
| format | Article |
| id | doaj-art-08adf3abda384ca986d6ceeaf4210cbb |
| institution | Kabale University |
| issn | 2950-6050 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Structural and Endovascular |
| spelling | doaj-art-08adf3abda384ca986d6ceeaf4210cbb2025-08-20T03:41:36ZengElsevierJTCVS Structural and Endovascular2950-60502024-09-01110000410.1016/j.xjse.2024.100004Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspectiveChristopher K. Mehta, MD0Tom X. Liu, MD, MS1Abigail S. Baldridge, DrPh2Jane Kruse, BSN3Jyothy Puthumana, MD4Robert O. Bonow, MD5Duc T. Pham, MD6Douglas R. Johnston, MD7S. Christopher Malaisrie, MD8Patrick M. McCarthy, MD9Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, Ill; Address for reprints: Christopher K. Mehta, MD, Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine, 676 N Saint Clair St, Suite 730, Chicago, IL 60611.Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiology, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiology, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllDivision of Cardiac Surgery, Northwestern University Feinberg School of Medicine and Bluhm Cardiovascular Institute, Northwestern Medicine, Chicago, IllObjective: To examine long-term surgical aortic valve replacement (SAVR) outcomes for young (ie, younger than age 65 years) patients with bicuspid aortic valve and aortic stenosis (AS) with or without concomitant aneurysm. Background: There are few studies evaluating the early and late outcomes of SAVR in young patients (younger than age 65 years) with bicuspid aortic valve and AS. Methods: Using institutional data from 2004 through 2022, 498 patients with bicuspid aortic valve younger than age 65 years underwent SAVR for AS with bioprosthetic valves. We examined operative outcomes, long-term valve durability, and reintervention. Results: The total cohort comprised 281 patients undergoing isolated SAVR and 217 with concomitant aneurysm repair (SAVR/aneurysm). The average age was 55 ± 8 years, with Society of Thoracic Surgeons predicted risk of mortality score of median 0.7 (IQR 0.5, 1.0) and mean valve size of 25 mm. Operative mortality (0.7% vs 1.4%; P = .77) was similar between SAVR and SAVR/aneurysm patients. Predischarge permanent pacemaker implantation occurred in 1.6% (8 out of 498) patients. During overall follow-up of 5.0 years (IQR 1.8-9.9; range, 0.2-18.2 years), the cumulative incidence of reintervention at 10 years for structural valve degeneration (n = 33), including valve-in-valve (n = 15) was 6.6% (8.1% SAVR vs 4.5% SAVR/aneurysm; P = .66). No mortality was observed for valve-in-valve or redo-SAVR. Moderate or greater aortic regurgitation and paravalvular leak were observed in 6.5% and 0.3%, respectively, at most recent follow-up. Conclusions: Bicuspid AS is common in patients younger than 65 years and management includes consideration of future valve intervention. SAVR confers excellent operative and reoperative outcomes, 10-year durability, and valve function. These results may support initial SAVR when considering lifetime management of AS.http://www.sciencedirect.com/science/article/pii/S2950605024000044aortic valve replacementaortic stenosislifetime managementbicuspid aortic valve |
| spellingShingle | Christopher K. Mehta, MD Tom X. Liu, MD, MS Abigail S. Baldridge, DrPh Jane Kruse, BSN Jyothy Puthumana, MD Robert O. Bonow, MD Duc T. Pham, MD Douglas R. Johnston, MD S. Christopher Malaisrie, MD Patrick M. McCarthy, MD Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective JTCVS Structural and Endovascular aortic valve replacement aortic stenosis lifetime management bicuspid aortic valve |
| title | Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective |
| title_full | Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective |
| title_fullStr | Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective |
| title_full_unstemmed | Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective |
| title_short | Long-term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosisCentral MessagePerspective |
| title_sort | long term durability of bioprosthetic aortic valve replacement in young patients with bicuspid aortic stenosiscentral messageperspective |
| topic | aortic valve replacement aortic stenosis lifetime management bicuspid aortic valve |
| url | http://www.sciencedirect.com/science/article/pii/S2950605024000044 |
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