Bioprosthetic aortic valve replacement: revisiting prosthesis choice in patients younger than 50 years old
Samuel R. Schnittman, MD, David H. Adams, MD, Shinobu Itagaki, MD, Nana Toyoda, MD, Natalia N. Egorova, PhD, Joanna Chikwe, MD
OBJECTIVE:
Aortic prosthesis choice is controversial in young adults because robust comparative outcome data are lacking. We therefore compared mortality and morbidity in young adults after bioprosthetic versus mechanical aortic valve replacement.
METHODS:
This was a retrospective analysis of 5111 patients aged 18 to 50 years undergoing primary aortic valve replacement in California and New York State from 1997 to 2006. Median follow-up time was 11.8 years (maximum 18.9 years). The primary endpoint was mortality; secondary endpoints were stroke, bleeding, and reoperation. Propensity score matching yielded 1175 patient pairs.
CONCLUSIONS:
Although lifetime risks are represented incompletely, these findings suggest that in adults aged 18-50 years, bioprostheses are a reasonable alternative to mechanical valves for aortic valve replacement.
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Publications
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2-Year Clinical and Echocardiography Follow-Up of Transcatheter Mitral Valve Replacement With the Transapical Intrepid System
Vinayak Bapat, Eric Weiss, Sean Pinney, David H Adams, Angie Zhang , Michael Mack, Martin B Leon, et al. -
Optimal timing of Ross operation in children: A moving target?
Igor E Konstantinov, Emile Bacha, David Barron, Tirone David, Joseph Dearani, Yves d'Udekem, Ismail El-Hamamsy, Hani K Najm, Pedro J Del Nido, Christian Pizarro, Peter Skillington, Vaughn A Starnes, David Winlaw -
Mitral Valve Intervention in Elderly or High-Risk Patients: A Review of Current Surgical and Interventional Management
Maheedhar Gedela, Busra Cangut, Lucy Safi, Parasuram Krishnamoorthy, Dimosthenis Pandis, Ahmed El-Eshmawi, Gilbert H L Tang -
Total artificial heart implantation as a bridge to transplantation in the United States
Shinobu Itagaki, Nana Toyoda, Natalia Egorova, Erick Sun, Timothy Lee, Percy Boateng, Gregory Gibson, Noah Moss, Donna Mancini, David H Adams, Anelechi C Anyanwu