Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis
Introduction. Recent national guidelines recommending mitral valve replacement (MVR) for severe secondary mitral regurgitation have resulted in an increased utilization of mitral bioprosthesis. There is a paucity of data on how longitudinal clinical outcomes vary by prosthesis type. We examined long...
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2023-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2023/2111843 |
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| author | M. Broadwin N. Ramkumar D. J. Malenka R. D. Quinn C. S. Ross F. Hirashima J. D. Klemperer R. S. Kramer G. L. Sardella B. Westbrook A. W. Discipio A. Iribarne M. P. Robich |
| author_facet | M. Broadwin N. Ramkumar D. J. Malenka R. D. Quinn C. S. Ross F. Hirashima J. D. Klemperer R. S. Kramer G. L. Sardella B. Westbrook A. W. Discipio A. Iribarne M. P. Robich |
| author_sort | M. Broadwin |
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| description | Introduction. Recent national guidelines recommending mitral valve replacement (MVR) for severe secondary mitral regurgitation have resulted in an increased utilization of mitral bioprosthesis. There is a paucity of data on how longitudinal clinical outcomes vary by prosthesis type. We examined long-term survival and risk of reoperation between patients having bovine vs. porcine MVR. Study Design. A retrospective analysis of MVR or MVR + coronary artery bypass graft (CABG) from 2001 to 2017 among seven hospitals reporting to a prospectively maintained clinical registry was conducted. The analytic cohort included 1,284 patients undergoing MVR (801 bovine and 483 porcine). Baseline comorbidities were balanced using 1 : 1 propensity score matching with 432 patients in each group. The primary end point was all-cause mortality. Secondary end points included in-hospital morbidity, 30-day mortality, length of stay, and risk of reoperation. Results. In the overall cohort, patients receiving porcine valves were more likely to have diabetes (19% bovine vs. 29% porcine; p<0.001), COPD (20% bovine vs. 27% porcine; p=0.008), dialysis or creatinine >2 mg/dL (4% bovine vs. 7% porcine; p=0.03), and coronary artery disease (65% bovine vs. 77% porcine; p<0.001). There was no difference in stroke, acute kidney injury, mediastinitis, pneumonia, length of stay, in-hospital morbidity, or 30-day mortality. In the overall cohort, there was a difference in long-term survival (porcine HR 1.17 (95% CI: 1.00–1.37; p=050)). However, there was no difference in reoperation (porcine HR 0.56 (95% CI: 0.23–1.32; p=0.185)). In the propensity-matched cohort, patients were matched on all baseline characteristics. There was no difference in postoperative complications or in-hospital morbidity and 30-day mortality. After 1 : 1 propensity score matching, there was no difference in long-term survival (porcine HR 0.97 (95% CI: 0.81–1.17; p=0.756)) or risk of reoperation (porcine HR 0.54 (95% CI: 0.20–1.47; p=0.225)). Conclusions. In this multicenter analysis of patients undergoing bioprosthetic MVR, there was no difference in perioperative complications and risk of reoperation of long-term survival after matching. |
| format | Article |
| id | doaj-art-2f939e79f5ce4562830e6719c0134663 |
| institution | OA Journals |
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| publishDate | 2023-01-01 |
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| spelling | doaj-art-2f939e79f5ce4562830e6719c01346632025-08-20T02:08:09ZengWileyCardiology Research and Practice2090-05972023-01-01202310.1155/2023/2111843Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter AnalysisM. Broadwin0N. Ramkumar1D. J. Malenka2R. D. Quinn3C. S. Ross4F. Hirashima5J. D. Klemperer6R. S. Kramer7G. L. Sardella8B. Westbrook9A. W. Discipio10A. Iribarne11M. P. Robich12Department of SurgeryGeisel School of Medicine at Dartmouth CollegeDepartment of MedicineDepartment of SurgeryDepartment of MedicineDepartment of SurgeryNorthern Light CardiologyDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryDepartment of SurgeryJohns Hopkins HospitalIntroduction. Recent national guidelines recommending mitral valve replacement (MVR) for severe secondary mitral regurgitation have resulted in an increased utilization of mitral bioprosthesis. There is a paucity of data on how longitudinal clinical outcomes vary by prosthesis type. We examined long-term survival and risk of reoperation between patients having bovine vs. porcine MVR. Study Design. A retrospective analysis of MVR or MVR + coronary artery bypass graft (CABG) from 2001 to 2017 among seven hospitals reporting to a prospectively maintained clinical registry was conducted. The analytic cohort included 1,284 patients undergoing MVR (801 bovine and 483 porcine). Baseline comorbidities were balanced using 1 : 1 propensity score matching with 432 patients in each group. The primary end point was all-cause mortality. Secondary end points included in-hospital morbidity, 30-day mortality, length of stay, and risk of reoperation. Results. In the overall cohort, patients receiving porcine valves were more likely to have diabetes (19% bovine vs. 29% porcine; p<0.001), COPD (20% bovine vs. 27% porcine; p=0.008), dialysis or creatinine >2 mg/dL (4% bovine vs. 7% porcine; p=0.03), and coronary artery disease (65% bovine vs. 77% porcine; p<0.001). There was no difference in stroke, acute kidney injury, mediastinitis, pneumonia, length of stay, in-hospital morbidity, or 30-day mortality. In the overall cohort, there was a difference in long-term survival (porcine HR 1.17 (95% CI: 1.00–1.37; p=050)). However, there was no difference in reoperation (porcine HR 0.56 (95% CI: 0.23–1.32; p=0.185)). In the propensity-matched cohort, patients were matched on all baseline characteristics. There was no difference in postoperative complications or in-hospital morbidity and 30-day mortality. After 1 : 1 propensity score matching, there was no difference in long-term survival (porcine HR 0.97 (95% CI: 0.81–1.17; p=0.756)) or risk of reoperation (porcine HR 0.54 (95% CI: 0.20–1.47; p=0.225)). Conclusions. In this multicenter analysis of patients undergoing bioprosthetic MVR, there was no difference in perioperative complications and risk of reoperation of long-term survival after matching.http://dx.doi.org/10.1155/2023/2111843 |
| spellingShingle | M. Broadwin N. Ramkumar D. J. Malenka R. D. Quinn C. S. Ross F. Hirashima J. D. Klemperer R. S. Kramer G. L. Sardella B. Westbrook A. W. Discipio A. Iribarne M. P. Robich Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis Cardiology Research and Practice |
| title | Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis |
| title_full | Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis |
| title_fullStr | Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis |
| title_full_unstemmed | Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis |
| title_short | Long-Term Outcomes of Bovine versus Porcine Mitral Valve Replacement: A Multicenter Analysis |
| title_sort | long term outcomes of bovine versus porcine mitral valve replacement a multicenter analysis |
| url | http://dx.doi.org/10.1155/2023/2111843 |
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