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3 . 2022

Medium-term results of aortic valve replacement with biological prosthesis: a single-centre retrospective study

Abstract

Aim – to analyze the medium-term results of aortic valve (AV) replacement with a biological prosthesis in our center of cardiovascular surgery.

Material and methods. 528 patients with AV pathology [269 men (51%)/259 women (49%)] were included in the retrospective study. Inclusion criteria: patients aged ≥18 years who underwent aortic valve replacement with a biological prosthesis. Exclusion criteria: prosthetics of ≥2 valves. The median age was 65 [62–70] years. There were 25 (4.7%) patients with infective endocarditis, and 61 (11.6%) had bicuspid AV. The median follow-up period was 37.8 [2.2–77.4] months.

Results. Combined interventions were performed in 87 (16.5%) cases. Hospital mortality was 1.1%. In the early postoperative period, 14 (2.7%) patients were indicated for implantation of a permanent pacemaker due to conduction disturbances. 2 (0.4%) patients developed perioperative myocardial injury, the number of strokes was 8 (1.5%). 10-year overall survival, freedom from cardiovascular death, stroke, freedom from reoperation, freedom from prosthetic infective endocarditis, freedom from degeneration were 58, 84.6, 93.3, 77.7, 95.1 and 87.2% respectively. By the end of the observation period, the median of the peak and average gradient on the biological prosthesis was 32 (25–40) and 18 (14–25) mm Hg, and aortic regurgitation ≥2 degree was detected in 10 (5%) patients.

Conclusion. The long-term survival and durability of Braile Biomedica, SJM Biocor biological prostheses are the same as for any other biological prosthesis available.

Keywords:aortic stenosis; aortic regurgitation; acquired heart disease; aortic valve replacement; aortic valve; biological prosthesis

Funding. The study had no sponsor support.
Conflict of interest. The authors declare no conflict of interest.
For citation: Enginoev S.T., Kondratyev D.A., Tsaroev B.S., Мagomedov G.M., Rashidova T.K., Abdurahmanov A.A., Аbdulmedzhidova U.K., Ziankou A.A., Chernov I.I., Tarasov D.G. Medium-term results of aortic valve replacement with biological prosthesis: a single-centre retrospective study. Clinical and Experimental Surgery. Petrovsky Journal. 2022; 10 (3): 28–37. DOI: https://doi.org/10.33029/2308-1198-2022-10-3-28-37  (in Russian)

References

1.     Otto C.M., Nishimura R.A., Bonow R.O., Krieger E.V., Mack M., Mcleod C., et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease. J Am Coll Cardiol. 2021; 77 (4): e25–197. DOI: https://doi.org/10.1016/j.jacc.2020.11.018  

2.     Vahanian A., Beyersdorf F., Praz F., Milojevic M., Baldus S., Bauersachs J., et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J. 2021; 43 (118): 1–72. DOI: https://doi.org/10.1093/eurheartj/ehab395  

3.     Bockeria L.A. (ed.). Cardiovascular Surgery – 2019. Moscow: NMITsSSKh im. A.N. Bakuleva Minzdrava Rossii, 2020: 294 p. (in Russian)

4.     Zoghbi W.A., Adams D., Bonow R.O., Enriquez-Sarano M., Foster E., Grayburn P.A., et al. Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance. J Am Soc Echocardiogr. 2017; 30: 303–71. DOI: https://doi.org/10.1016/j.echo.2017.01.007  

5.     Baumgartner H., Hung J., Bermejo J., Chambers J.B., Edvardsen T., Goldstein S., et al. Recommendations on the echocardiographic assessment of aortic valve stenosis: a focused update from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr. 2017; 30: 372–92. DOI: https://doi.org/10.1016/j.echo.2017.02.009  

6.     Brown J.M., O’Brien S.M., Wu C., Sikora J.A.H., Griffith B.P., Gammie J.S. Isolated aortic valve replacement in North America comprising 108,687 patients in 10 years: changes in risks, valve types, and outcomes in the Society of Thoracic Surgeons National Database. J Thorac Cardiovasc Surg. 2009; 137: 82–90. DOI: https://doi.org/10.1016/j.jtcvs.2008.08.015  

7.     Wallen T., Habertheuer A., Bavaria J.E., Hughes G.C., Badhwar V., Jacobs J.P., et al. Elective aortic root replacement in North America: analysis of STS adult cardiac surgery database. Ann Thorac Surg. 2019; 107: 1307–12. DOI: https://doi.org/10.1016/j.athoracsur.2018.12.039  

8.     Mourad F., Haddad A., Nowak J., Elbarraki M., Elhmidi Y., Jasarevic M., et al. Impact of non-valvular non-coronary concomitant procedures on outcomes of surgical aortic valve replacement in intermediate risk patients. J Clin Med. 2021; 10: 1–11. DOI: https://doi.org/10.3390/jcm10235592  

9.     Bourguignon T., Bouquiaux-Stablo A.L., Candolfi P., Mirza A., Loardi C., May M.A., et al. Very long-term outcomes of the Carpentier-Edwards Perimount valve in aortic position. Ann Thorac Surg. 2015; 99: 831–7. DOI: https://doi.org/10.1016/j.athoracsur.2014.09.030  

10. Borger M.A., Ivanov J., Armstrong S., Christie-Hrybinsky D., Feindel C.M., David T.E. Twenty-year results of the Hancock II bioprosthesis. J Heart Valve Dis. 2006; 15: 49–56.

11. Azeredo L.G., Veronese E.T., Santiago J.A., Brandão C.M., Pomerantzeff P.M., Jatene F.B. Late outcome analysis of the Braile Biomédica® pericardial valve in the aortic position. Rev Bras Cir Cardiovasc. 2014; 29 (3): 316–21. DOI: 10.5935/1678-9741.20140081  

12. Persson M., Glaser N., Franco-Cereceda A., Nilsson J., Holzmann M.J., Sartipy U. Porcine vs bovine bioprosthetic aortic valves: long-term clinical results. Ann Thorac Surg. 2021; 111: 529–35. DOI: https://doi.org/10.1016/j.athoracsur.2020.05.126

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CHIEF EDITOR
CHIEF EDITOR
Sergey L. Dzemeshkevich
MD, Professor (Moscow, Russia)

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