Freestyle stentless bioprosthesis for aortic valve therapy: 17-year clinical results
| Autor: | Bernd Niemann, Juergen Ennker, Andreas Boening, Markus Meilwes, Ina Carolin Ennker, Philippe Grieshaber, Joern Pons-Kuehnemann |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Reoperation Pulmonary and Respiratory Medicine Aortic valve medicine.medical_specialty Time Factors medicine.medical_treatment Kaplan-Meier Estimate 030204 cardiovascular system & hematology Prosthesis Design Prosthesis Disease-Free Survival Coronary artery disease 03 medical and health sciences Postoperative Complications 0302 clinical medicine Valve replacement Aortic valve replacement Risk Factors Germany Internal medicine medicine Humans Myocardial infarction Stroke Aged Aged 80 and over Bioprosthesis Heart Valve Prosthesis Implantation business.industry General Medicine Middle Aged medicine.disease Surgery Treatment Outcome medicine.anatomical_structure 030228 respiratory system Aortic Valve Heart Valve Prosthesis Heart failure Cardiology Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Asian Cardiovascular and Thoracic Annals. 24:868-874 |
| ISSN: | 1816-5370 0218-4923 |
| Popis: | Background Aortic valve replacement with stentless bioprostheses has been shown to produce lower aortic gradients than stented bioprostheses, thus facilitating left ventricular mass regression and preventing heart failure. We sought to determine the long-term results of stentless biological aortic valve replacement over a 17-year follow-up. Methods Between 1996 and 2012, 2551 patients underwent isolated aortic valve replacement with a stentless prosthesis (Medtronic Freestyle) at a single center. The mean patient age was 72 ± 10 years, 55% were male, 24.1% were in New York Heart Association class I and II, 9.6% had undergone previous surgery, 18.1% had coronary artery disease, and 23.1% had diabetes. For the long-term follow-up, patients were contacted in writing and by telephone; follow-up was 96.3% complete, resulting in 11,546 patient-years. Results At 30 days, mortality (5.4%), renal failure (3.9%), myocardial infarction (0.7%), and stroke (1.4%) rates were acceptable. During long-term follow-up of 1–17 years, the bleeding rate (2.9%) was higher than the thromboembolic event rate (0.7%) despite 18.1% of patients being on oral anticoagulants. New pacemaker implantation (4.5%; 0.87 events/100 patient-years), neurological disorders (5%; 0.52 events/100 patient-years), valve insufficiency (0.7%; 0.16 events/100 patient-years), paravalvular leakage (0.4%; 0.09 events/100 patient-years) and reoperation due to valvular complications (0.7%; 0.38 events/100 patient-years) were rare. Long-term survival was 41.8% ± 1.6 after 10 years, 21.3% ± 2.3 after 15 years, and 12.1% ± 3.9 after 17 years. Conclusion Long-term results after aortic valve replacement with stentless biological prostheses compare favorably with those obtained with stented bioprostheses. |
| Databáze: | OpenAIRE |
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