Bioprosthetic valve longevity in the elderly: An 18-year longitudinal study

Pupello, Dennis F.; Bessone, L; Hiro, Stephen P.; Lopez-Cuenca, Enrique; Glatterer, M.S.; Angell, William W.; Brock, John C.; Alkire, Mark J.; Izzo, Edward G.; Sanabria, G.; Ebra, George

doi:10.1016/0003-4975(95)00298-y

Cited by 26 publications

(8 citation statements)

References 13 publications

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“…However, mortality rates in older age groups of 13.4% to 14.3% have been reported for mitral valve replacement. 2,3,9,11,14,[16][17][18][19][20] We previously reported 5 an early hospital mortality rate of 8% with mechanical valves in patients over 50 years of age compared with a rate of 14.3% in the study by Pupello and colleagues 2 in patients over 70 years of age.…”

Section: Mitral Valve Replacement With Bioprosthesis Katircioglumentioning

confidence: 98%

“…3,4 Recognizing that the need for valve operations in the elderly is increasing has focused attention on the choice of prostheses. 2 In some instances the use of biological valves in elderly patients may be justified because of contraindications to mechanical prostheses. 1 In this study we report our clinical experience with a biological mitral valve prosthesis.…”

Section: Introductionmentioning

confidence: 99%

“…As this segment of the population continues to grow, more patients will require cardiac operations. 2 Bioprostheses are considered to ensure a good quality of life with low rates of thromboembolism, structural valve deterioration, anticoagulant-related bleeding, or thrombosis of the valve. In populations with a low compliance with anticoagulant regimens, the use of mechanical valves is associated with high rates of thromboembolism, valve thrombosis, or fatal anticoagulant-related hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

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Mitral Valve Replacement with Bioprosthesis in Age Group Fifty to Sixty-Five Years

Katırcıoğlu

Yamak

Uluş

et al. 1998

Asian Cardiovasc Thorac Ann

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Between 1982 and 1990, 151 patients aged 50 to 65 years of age underwent isolated mitral valve replacement with a bioprosthesis. Overall hospital mortality was 10.6% (16/151). The total cumulative follow-up period was 527.6 patient-years with a mean of 4.34 ± 2.53 years and a range of 2 months to 10.9 years. During the follow-up period, 27 patients (5.11% per patient-year) developed bioprosthesis dysfunction of whom 26 were reoperated and one was treated medically, 4 patients had thromboembolic complications (0.75% per patient-year), one patient (0.18% per patient-year) had anticoagulant-related bleeding, and two patients (0.37% per patient-year) had a paravalvular leak (one was reoperated). Total valve-related complications were 6.44% per patient-year. Late mortality was 2.65% per patient-year (14/ 151). Ten-year actuarial survival was 78.5%. Freedom from bioprosthesis dysfunction was 56.6%, from thromboembolic complications 95.8%, and from all complications 49.6%. Our findings of a high rate of bioprosthesis dysfunction as well as a low rate of thromboembolic complications after mitral valve replacement with a bioprosthesis in older patients suggests that the use of bioprostheses should be limited.

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Section: Mitral Valve Replacement With Bioprosthesis Katircioglumentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mitral Valve Replacement with Bioprosthesis in Age Group Fifty to Sixty-Five Years

Katırcıoğlu

Yamak

Uluş

et al. 1998

Asian Cardiovasc Thorac Ann

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“…Ces résultats corroborent ceux de la littérature [4,[6][7][8][9] qui révèle que la dysfonction d'une PM est exceptionnelle. Il est actuellement bien établi que la dégénérescence d'une PB dépend de la position de la PV (plus fréquente en position mitrale), de l'âge du patient au moment du RV et du temps de suivi après l'intervention [9,[12][13][14].…”

Section: Dégénérescence De La Prothèse Valvulaireunclassified

“…La dysfonction d'une PM est rarissime et ne justifie pas un suivi échocardiographique de routine. Un suivi échocardiographique de routine à la recherche de signe de dégénérescence chez un patient porteur d'une PB peut se justifier dès 5 ans après à un RVM et dès 8 ans après un RVA surtout si l'intervention a eu lieu avant l'âge respectivement de 65-70 ans et 60-65 ans [9,[12][13][14].…”

Section: Apport De L'échocardiographie Dans Les Complications Non Liéunclassified

Evolution à moyen terme et rôle de l'échocardiographie après remplacement valvulaire

Zaza¹,

Jaussi²,

Crittin³

et al. 2007

Schweiz Ärzteztg

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SummaryAims: The aim of the study was to evaluate the rate of occurrence of complications associated with prosthetic valves (PV) in ambulatory practice and to further evaluate the usefulness of echocardiography in the diagnosis and follow-up of these complications. Method: The study included 226 patients with a mean age of 57.7 ± 14.7 years in whom 253 PV (209 mechanical and 44 biological) were implanted. Immediate post-operative echocardiography was performed followed by annual echographic control studies. Results: Mean follow-up was 6.8 ± 3.8 years, corresponding to 1526 patient years. Complication-free patients numbered 72.7 ± 3.5% in the presence of mechanical prosthetic valves (MV) and 68.6 ± 8.1% in the presence of biological valves (BV) (p = 0.55). With respect to positions, complication-free patients numbered 68.3 ± 4.0%, 85.3 ± 4.8% and 51.9 ± 15% with PV in the aortic, mitral and mitro-aortic positions respectively (p = 0.54). The haemorrhagic and endocarditic risk was most important in the presence of a MV. All cases of PV degeneration occurred in patients with a BV in the mitral position. There was a tendency towards an increased incidence of paravalvalvular leaks and re-interventions in the presence of BV and a tendency towards an increased incidence of thrombo-embolic complications with PV in the aortic position. A PV linked complication was detected on average every 24.4 echocardiographs. Conclusion: The incidence of PV linked complications is low with a majority of patients free of any complications following valve replacement. The type and position of the PV only appears to influence the incidence of haemorrhages, degenerescence, re-intervention and endocarditis. The usefulness of routine echocardiographic follow-up therefore seems limited. An echocardiographic follow-up is, however, justified in certain settings, namely in the presence of para-valvular leaks, increased trans-valvular gradients, un- 237Travail original Kardiovaskuläre Medizin 2007;10: Nr 7-8 liées à la présence d'une PV est faible et la majorité des patients ne présente aucune complication suite au remplacement valvulaire. Le type et la localisation de la PV n'influence que l'incidence des hémorragies, des dégénéres-cences, des ré-interventions et des endocardites. L'apport d'un suivi échocardiographique de routine est faible. Un suivi échocardiogra-phique est cependant justifié en présence d'une fuite paravalvulaire, d'un gradient transvalvulaire élevé, d'une évolution clinique défavorable ou d'une PB âgée de plusieurs années.

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