Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure

Overview

Journal J Am Heart Assoc

Specialty Cardiology & Vascular Diseases

Date 2023 Dec 29

PMID 38156561

Authors

Cheng-Yu Chen

Chun-Yu Chen

Feng-Cheng Chang

Yu-Ting Cheng

Victor Chien-Chia Wu

Chia-Pin Lin

Yi-Hsin Chan

Kuo-Chun Hung

Pao-Hsien Chu

Shao-Wei Chen

Affiliations

Soon will be listed here.

Abstract

Background: The widely used Bentall procedure is the criterion standard treatment for aortic root pathology. Studies comparing the long-term outcomes of bioprosthetic and mechanical valves in patients undergoing the Bentall procedure are limited.

Methods And Results: Patients who underwent the Bentall procedure with a bioprosthetic or mechanical valve between 2001 and 2018 were identified from Taiwan's National Health Insurance Research Database. The primary outcome of interest was all-cause mortality. Inverse probability of treatment weighting was performed to compare the 2 prosthetic types. In total, 1052 patients who underwent the Bentall procedure were identified. Among these patients, 351 (33.4%) and 701 (66.6%) chose bioprosthetic and mechanical valves, respectively. After inverse probability of treatment weighting, no significant differences in the in-hospital mortality (odds ratio, 0.96 [95% CI, 0.77-1.19]; =0.716) and all-cause mortality (34.1% vs. 38.1%; hazard ratio, 0.90 [95% CI, 0.78-1.04]; =0.154) were observed between the groups. The benefits of relative mortality associated with mechanical valves were apparent in younger patients and persisted until ≈50 years of age.

Conclusions: No differences in survival benefits were observed between the valves in patients who underwent the Bentall procedure. Additionally, bioprosthetic valves may be a reasonable choice for patients aged >50 years when receiving the Bentall procedure in this valve-in-valve era.

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