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Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Werner, P; Gritsch, J; Kaider, A; Coti, I; Osorio, E; Mahr, S; Stelzmueller, ME; Kocher, A; Laufer, G; Andreas, M; Ehrlich, M.
Long Term Results of the Modified Bentall Procedure With Mechanical and Biological Composite Valve Grafts
FRONT CARDIOVASC MED. 2022; 9: 867732
Doi: 10.3389/fcvm.2022.867732
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PubMed
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- Co-authors Med Uni Graz
- Andreas Martin
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- Abstract:
- ObjectivesDespite the evident shift toward biological prostheses, the optimal choice of valve remains controversial in composite valve graft (CVG) replacement. We investigated long-term morbidity and mortality after CVG implantation in an all-comer cohort with a subgroup analysis of patients aged 50-70 years stratified after valve type. MethodsA total of 507 patients underwent the Bentall procedure with either a mechanical (MCVG, n = 299) or a biological (BCVG n = 208) CVG replacement between 2000 and 2020. A single-center analysis comprising clinical and telephone follow-up was conducted to investigate late mortality and morbidity ResultsThe 30-day mortality in all patients [age 56 +/- 14 years, 78.1% male, EuroSCORE II 3.12 (1.7; 7.1)] was 5.9%. Patients who were electively operated on had a 30-day mortality of 1.5% (n = 5) while it remained higher in urgent/emergent procedures (n = 25, 15.4%). Survival at 10 and 15 years was 78.19 +/- 2.26% and 72.6 +/- 3.2%, respectively. In patients aged 50-70 years (n = 261; MCVG = 151, BCVG = 110), survival did not differ significantly between the valve groups (p = 0.419). Multivariable analysis showed no significant impact of valve type on survival (p = 0.069). A time-varying relation with survival was notable, showing a higher risk in the MCVG group in the early postoperative phase, which declined compared to the BCVG group in the course of follow-up. ConclusionsThe Bentall technique presents with excellent mortality when performed electively. The type of valve prosthesis showed no statistically significant effect on mortality in patients aged 50-70 years. However, a time-varying relation showing an initially higher risk with MCVG which decreased compared to BCVG at long-term follow-up was notable. Further studies with even longer follow-up of BCVGs will clarify the ideal choice of prosthesis in this patient subset.
- Find related publications in this database (Keywords)
- modified Bentall procedure
- composite valve graft replacement
- valve-related adverse events
- aortic valve replacement
- aortic replacement