Early and mid-term outcomes after aortic valve intervention in patients with previous stentless or stented bioprostheses

Abstract

Background Limited data are available concerning comparative outcomes of redo aortic valve interventions, including surgery after aortic valve replacement (AVR) with either stented or stentless bioprostheses. We investigated the comparative outcomes of redo aortic valve interventions, including surgery after AVR with either stented or stentless bioprostheses. Methods The cohort consisted of 112 patients who underwent aortic valve intervention for infective endocarditis or structural valve deterioration between 2001 and 2020. One hundred patients received a stented valve (stented group) and 12 patients received a stentless valve (stentless group) during the initial surgery. Early and late outcomes were evaluated. Results The mean [IQR] ages during the current interventions were 66 [54, 77] years in the stented group and 74 [67, 79] years in the stentless group (P = 0.13). In the stented group, aortic valve interventions included redo AVRs with stented valves (n = 54), mechanical valves (n = 26), stentless valves (n = 16), and transcatheter aortic valve implantations (n = 4). In the stentless group, redo AVRs were performed with stented valves (n = 4), mechanical valves (n = 2), stentless valves (n = 1), and transcatheter valve implantations (n = 5). Hospital mortality was observed in 2 (2%) patients in the stented group and 1 (8%) patients in the stentless group (P = 0.29). The 5-year survival was 80.8% [66.8, 88.5] in the stented group and 91.7% [53.9, 98.8] in stentless group. Statistically significant differences in thromboembolisms were observed between the groups. Conclusions No significant differences in early and mid-term outcomes (except thromboembolism) after aortic valve interventions were detected between patients with stented and stentless AVRs.

Right anterior mini thoracotomy for redo cardiac surgery: case series from North America and Europe

“…When considering reintervening on a diseased prosthetic aortic valve, options include redo-surgical aortic valve replacement (SAVR) or valvein-valve (ViV) transcatheter aortic valve replacement (TAVR). Several studies over the past 10 years have demonstrated favourable outcomes with each of these strategies (1)(2)(3)(4)(5). Generally, it is believed TAVR offers a minimally-invasive low risk procedure, but with limited durability, whereas redo-SAVR is associated with higher risk, but greater durability.…”