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Comparative Study
. 2015 Oct;48(4):557-61.
doi: 10.1093/ejcts/ezu466. Epub 2014 Dec 18.

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

Martin Andreas  1 , Stephanie Wallner  2 , Kurt Ruetzler  3 , Dominik Wiedemann  2 , Marek Ehrlich  2 , Georg Heinze  4 , Thomas Binder  5 , Anton Moritz  6 , Michael J Hiesmayr  7 , Alfred Kocher  2 , Guenther Laufer  2
Affiliations
Comparative Study

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

Martin Andreas et al. Eur J Cardiothorac Surg. 2015 Oct.

Abstract

Objectives: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Aortic valve replacement; Biological heart valves; Bioprosthesis; Survival analysis.

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Figures

Figure 1:
Figure 1:
Postoperative transvalvular gradients. Blue: porcine valve; green: pericardial valve; a smoothing line for each group was obtained by a local regression function. Multiple measurements of each patient available were included.
Figure 2:
Figure 2:
Cumulative survival compared the age- and sex-matched population. The age- and sex-matched standard population represents the expected overall Austrian survival for the year 2005.
See this image and copyright information in PMC

References

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