Hemodynamic performance and clinical outcome of pericardial Perimount Magna and Porcine Hancock-II valves in aortic position.
J Card Surg
; 34(10): 1055-1061, 2019 Oct.
Article
em En
| MEDLINE
| ID: mdl-31389647
ABSTRACT
BACKGROUND:
We investigated hospital and midterm outcome of patients operated for an aortic valve replacement (AVR) with a pericardial Perimount or a Porcine Hancock-II valve.METHODS:
We analyzed 353 patients with Perimount Magna (n = 189) or Hancock-II valves (n = 164). Echocardiographic data, hospital outcome, and follow-up were collected and compared. The role of the type of valve on perioperative and midterm outcome was investigated.RESULTS:
Mean age was 75.3 ± 6.8 and 74.3 ± 7.1 years (P = .17) for Perimount and Hancock-II group, respectively. Fifty-four Perimount (28.6%) and 24 patients with Hancock-II (14.6%) required urgent procedures (P = .002), including six type-A dissections and five endocarditis. EuroSCORE-II was 3.1 ± 2.7% (Perimount) and 2.7 ± 2.2% (Hancock-II). Combined procedures were performed in 115 Perimount (60.8%) and 71 patients with Hancock (43.3%); redo procedures counted for 1% and 2.4%, respectively (P = .42). Mean valve size was 23.2 ± 1.8 mm for pericardial and 23.6 ± 1.9 mm for porcine valves (P = .08). Hospital mortality (6.3% vs 2.4%; P = .05), kidney failure (11.6% vs 9.8%; P = .73), and new pacemaker implantation rates (6.3% vs 3.0%; P = .21) were higher in the Perimount group reflecting the fact that more urgent, combined, and critical procedures were implanted with a Perimount Magna. Overall, 51 patients died over 60 months (34 Perimount, 17 Hancock), corresponding to a mortality of 5.3 per 100-persons year (95% confidence interval [CI] 3.8-7.4) and 3.0 (95% CI 1.8-4.8), respectively. Survival at 5 years was 76% (95% CI 68-82) and 83% (95% CI 74-89) in the Perimount and Hancock groups (log-rank test; P = .099).CONCLUSIONS:
We confirm a good clinical outcome of patients with AVR with modern pericardial or a porcine bioprosthesis. Despite better hemodynamic, the Perimount does not improve the midterm clinical outcome compared with the porcine valve.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Pericárdio
/
Bioprótese
/
Próteses Valvulares Cardíacas
/
Implante de Prótese de Valva Cardíaca
/
Doenças das Valvas Cardíacas
/
Hemodinâmica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Animals
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Card Surg
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Suíça