Choice of Aortic Valve Prosthesis in a Rapidly Aging and Long-Living Society

Sakamoto, Yoshimasa; Murayama, Yoshitake; Matsumura, Yuichi; Naruse, Hitomi; Bando, Ko; Hara, Kazuhiro

doi:10.5761/atcs.oa.16-00104

Cited by 13 publications

(10 citation statements)

References 27 publications

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“…In total, 22 studies were included in the final analysis, and the characteristics of the individual studies are summarized in Table 1 . Of those studies, one was an RCT study [ 8 ], 11 were PSM retrospective studies [ 1 , 3 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], and 10 were non-PSM retrospective studies [ 7 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ]. In total, 32,298 patients were included, of which 15,449 received mechanical prostheses, whereas 16,849 received biological prostheses.…”

Section: Resultsmentioning

confidence: 99%

“…Early death refers to in-hospital death or death occurring within 30 days after operation. In total, 14 [ 3 , 7 , 8 , 13 , 15 , 16 , 19 , 20 , 21 , 22 , 23 , 24 , 26 , 27 ] studies provided related details, 7 [ 3 , 8 , 13 , 15 , 16 , 19 , 20 ] of which were RCT or PSM retrospective studies. No significant difference in early mortality existed between mechanical and bioprosthetic prostheses regardless of whether only RCT or PSM retrospective studies were included.…”

Section: Resultsmentioning

confidence: 99%

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Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged Adults: A Systematic Review and Meta-Analysis

Jiang

Wang

Bian

et al. 2023

JCDD

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Background: Mechanical prostheses and bioprosthetic prostheses have their own advantages and disadvantages. Mechanical ones are recommended for younger patients (<50 years old), and bioprosthetic ones are recommended for older patients (>70 years old). There is still debate regarding which kind of prosthesis is better for middle-aged patients (50 to 70 years old) receiving aortic valve replacement (AVR). To solve this problem, we conducted this meta-analysis. Given that only one randomized controlled trial (RCT) study was included, we conducted a subgroup analysis of RCT and propensity score matching (PSM) retrospective studies to reduce the bias. Methods: We systematically searched articles related to clinical outcomes of mechanical and bioprosthetic prostheses in middle-aged patients receiving AVR in the PubMed, Cochrane Library, and China National Knowledge Infrastructure (CNKI) databases. The published date was up to 1 October 2022. Studies were excluded if not only middle-aged patients were included, or if they lacked direct comparisons between mechanical and bioprosthetic prostheses. Results: In total, 22 studies with 32,298 patients were included in the final analysis. The results show that patients aged between 50 and 70 receiving AVR with mechanical prostheses achieved better long-term survival and fewer reoperations and valve-related events but suffered more with bleeding events. No significant difference could be found in terms of early mortality and long-term cardiac death. The same results could be observed in the subgroup analysis of RCT and PSM retrospective studies. Conclusion: Both mechanical and bioprosthetic prostheses are beneficial to middle-aged patients undertaking AVR procedures. However, mechanical prostheses show better clinical outcomes in long-term survival and comorbidities. Individual recommendation is still necessary.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged Adults: A Systematic Review and Meta-Analysis

Jiang

Wang

Bian

et al. 2023

JCDD

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“…The general study characteristics are presented in Table 1 and in Table S1 (Supplementary Materials) . In total, 16 studies from 11 countries were included, 12 of which reported results from PMS cohorts [ 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 ], and a further 4 studies reported results from multivariate analysis [ 24 , 25 , 26 , 27 ]. Of those studies, only one was RCT study [ 26 ].…”

Section: Resultsmentioning

confidence: 99%

Surgical Aortic Valve Replacement in Patients Aged 50 to 70 Years: Mechanical or Bioprosthetic Valve? A Systematic Review

Sigala,

Kelesi,

Terentes-Printzios

et al. 2023

Healthcare

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Although transcatheter aortic valve implantation has emerged as a very attractive treatment option for severe aortic valve disease, surgical aortic valve replacement (SAVR) is still considered the standard-of-care, particularly in younger patients. However, selecting the appropriate type of valve prosthesis for this patient population can pose challenges. The aim of this systematic review was to investigate morbidity and mortality in patients aged 50–70 years who have undergone a first-time SAVR, and to define and compare the outcomes of mechanical valve (MV) and biological valve (BV) prosthesis. A systematic search was conducted to investigate the clinical outcomes of MVs and BVs in patients aged 50–70 years following the PRISMA guidelines. A total of 16,111 patients were included in the studies with an average follow-up of 10 years. A total of 16 studies were selected, 12 of which included propensity-score-matching (PMS) analysis and 4 of which obtained results via multivariate analysis. The vast majority (13 studies) showed no greater survival benefit in either MVs and BVs, while three studies showed an advantage of MVs over BVs. Regarding complications, bleeding was the most common adverse event in patients undergoing MV replacement, while for patients receiving BV prosthesis, it was structural valve deterioration and reoperation. Although the data suggest that the BV option could be a safe option in patients younger than 70 years, more studies with contemporary data are needed to draw firm conclusions on the risks and benefits of BV or MV in SAVR. Physicians should individualize the surgical plan based on patient characteristics.

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“…Thirteen studies involving 15,320 patients were included in this meta-analysis. Of the 13 studies, one was an RCT [18], and the remaining were PSM studies [19][20][21][22][23][24][25][26][27][28][29][30]. PRISMA flowchart of the study selection process is depicted in Figure 1.…”

Section: Study Selection and Patient Characteristicsmentioning

confidence: 99%

Long-Term Outcomes of Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Vankayalapati,

Segun-Omosehin,

El Ghazal

et al. 2024

Cureus

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This study aimed to investigate the safety and efficacy of bioprosthetic (BV) versus mechanical valves (MV) on long-term outcomes in 50-to 70-year-old aortic stenosis (AS) patients. A literature search for articles published until April 2023 yielded 13 eligible studies, with 15,320 patients divided into BV (n = 7,320) and MV (n = 8,000) cohorts. The review was registered prospectively with PROSPERO (CRD42021278777). MV demonstrated a favorable hazard ratio (HR: 1.12, 95% CI: 1.00-1.25, I 2 = 60%) and higher survival rates at 5

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Choice of Aortic Valve Prosthesis in a Rapidly Aging and Long-Living Society

Cited by 13 publications

References 27 publications

Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged Adults: A Systematic Review and Meta-Analysis

Mechanical versus Bioprosthetic Aortic Valve Replacement in Middle-Aged Adults: A Systematic Review and Meta-Analysis

Surgical Aortic Valve Replacement in Patients Aged 50 to 70 Years: Mechanical or Bioprosthetic Valve? A Systematic Review

Long-Term Outcomes of Mechanical Versus Bioprosthetic Aortic Valve Replacement: A Systematic Review and Meta-Analysis

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