Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates
Background: Aortic valve replacement (AVR) is the definitive therapy for patients with severe aortic valve stenosis (AoS). The aim of this work is to compare the effect of a mechanical prosthesis (MP) and a bioprosthesis (BP) on the survival of patients aged 50–65 years after AVR. Methods: The retro...
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2025-01-01
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| author | Tomáš Toporcer Štefan Lukačín Andrea Kraus Marián Homola Anton Bereš Michal Trebišovský Denis Radótzy Vilém Rohn Adrián Kolesár |
| author_facet | Tomáš Toporcer Štefan Lukačín Andrea Kraus Marián Homola Anton Bereš Michal Trebišovský Denis Radótzy Vilém Rohn Adrián Kolesár |
| author_sort | Tomáš Toporcer |
| collection | DOAJ |
| description | Background: Aortic valve replacement (AVR) is the definitive therapy for patients with severe aortic valve stenosis (AoS). The aim of this work is to compare the effect of a mechanical prosthesis (MP) and a bioprosthesis (BP) on the survival of patients aged 50–65 years after AVR. Methods: The retrospective analysis included 276 patients aged 50 to 65 years who had undergone isolated AVR for AoS; 161 patients were implanted with an MP and 115 with a BP. Patient survival, adjusted for age, gender and risk parameters affecting survival, was assessed. A subgroup analysis was performed on the 208 patients with a modern valve (prosthesis models that are no longer used in clinical practice were removed from the sample). Results: After adjusting for risk factors for overall survival as well as for age and sex, the implantation of an MP did not have a significant effect on overall survival in comparison to a BP, at a median follow-up of 10.3 years (<i>p</i> = 0.477). The size of the MP had no significant effect on overall survival either (HR: 1.29; 95%CI: 0.16–10.21; <i>p</i> = 0.812). However, the indexed effective orifice area of the BP had a positive effect on overall survival (HR: 0.09; 95%CI: 0.01–0.78; <i>p</i> = 0.029). Conclusions: The estimated survival of patients aged between 50 and 65 years after implantation of a BP with a sufficiently large indexed effective orifice area may exceed that of patients with an MP. |
| format | Article |
| id | doaj-art-d1e4bd539839488d8e29893ba8deb08c |
| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-01-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-d1e4bd539839488d8e29893ba8deb08c2025-08-20T03:12:08ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-01-011224410.3390/jcdd12020044Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival RatesTomáš Toporcer0Štefan Lukačín1Andrea Kraus2Marián Homola3Anton Bereš4Michal Trebišovský5Denis Radótzy6Vilém Rohn7Adrián Kolesár8Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaInstitute of Mathematics and Statistics, Faculty of Science, Masaryk University, 602 00 Brno, Czech RepublicDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaII. Surgery Department–Cardiovascular Surgery, General University Hospital and First Faculty of Medicine, Charles University, 128 08 Prague, Czech RepublicDepartment of Heart Surgery, East Slovak Institute for Cardiovascular Diseases and Medical Faculty of Pavol Jozef Šafárik University, 04001 Košice, SlovakiaBackground: Aortic valve replacement (AVR) is the definitive therapy for patients with severe aortic valve stenosis (AoS). The aim of this work is to compare the effect of a mechanical prosthesis (MP) and a bioprosthesis (BP) on the survival of patients aged 50–65 years after AVR. Methods: The retrospective analysis included 276 patients aged 50 to 65 years who had undergone isolated AVR for AoS; 161 patients were implanted with an MP and 115 with a BP. Patient survival, adjusted for age, gender and risk parameters affecting survival, was assessed. A subgroup analysis was performed on the 208 patients with a modern valve (prosthesis models that are no longer used in clinical practice were removed from the sample). Results: After adjusting for risk factors for overall survival as well as for age and sex, the implantation of an MP did not have a significant effect on overall survival in comparison to a BP, at a median follow-up of 10.3 years (<i>p</i> = 0.477). The size of the MP had no significant effect on overall survival either (HR: 1.29; 95%CI: 0.16–10.21; <i>p</i> = 0.812). However, the indexed effective orifice area of the BP had a positive effect on overall survival (HR: 0.09; 95%CI: 0.01–0.78; <i>p</i> = 0.029). Conclusions: The estimated survival of patients aged between 50 and 65 years after implantation of a BP with a sufficiently large indexed effective orifice area may exceed that of patients with an MP.https://www.mdpi.com/2308-3425/12/2/44aortic valve replacementaortic valve stenosismechanical prosthesisbioprosthesis |
| spellingShingle | Tomáš Toporcer Štefan Lukačín Andrea Kraus Marián Homola Anton Bereš Michal Trebišovský Denis Radótzy Vilém Rohn Adrián Kolesár Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates Journal of Cardiovascular Development and Disease aortic valve replacement aortic valve stenosis mechanical prosthesis bioprosthesis |
| title | Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates |
| title_full | Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates |
| title_fullStr | Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates |
| title_full_unstemmed | Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates |
| title_short | Bioprostheses and Mechanical Prostheses for Aortic Valve Replacement in Patients Aged 50 to 65 Years Offer Similar Long-Term Survival Rates |
| title_sort | bioprostheses and mechanical prostheses for aortic valve replacement in patients aged 50 to 65 years offer similar long term survival rates |
| topic | aortic valve replacement aortic valve stenosis mechanical prosthesis bioprosthesis |
| url | https://www.mdpi.com/2308-3425/12/2/44 |
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