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Page 53
March 25-26, 2019 | Amsterdam, Netherlands
CARDIOLOGY
AND CARDIAC NURSING
3
rd
World Congress on
Cardiology Summit 2019
Journal of Cardiovascular Medicine and Therapeutics | Volume 3
OF EXCELLENCE
IN INTERNATIONAL
MEETINGS
alliedacademies.comYEARS
Note:
CONTEMPORARY HOSPITAL OUTCOMES OF TISSUE VERSUS MECHANICAL
AORTIC VALVE SURGERY : A MULTICENTER STUDY
Jeffrey Shuhaiber
Baystate Medical Center, USA
Objectives:
Substantial controversy surrounds the choice between a mechanical versus bioprosthetic pros-
thesis for Aortic Valve Replacement (AVR), based on age. This study aims to investigate national trends and
in-hospital outcomes of the 2 prosthesis choices.
Methods:
All patients aged >18 years in the National Inpatient Sample who received an AVR between 1998
and 2011 were considered. Valve-type use was examined by patient, procedural, and hospital characteristics,
after which we matched patients based on their propensity score for receiving a bioprosthetic valve and com-
pared their in-hospital outcomes.
Results:
Bioprosthetic valves comprised 53.3% of 767,375 implanted valves, an increase in use from 37.7%
in the period 1998 to 2001 to 63.6% in the period 2007 to 2011. The median age was 74 years for patients
receiving bioprosthetic valves, and 67 years for those receiving mechanical valves. Use of bioprosthetic valves
increased across all age groups, most markedly in patients age 55 to 64 years. Compared with patients receiv-
ing mechanical valves, these patients had a higher incidence of renal disease (8.0% vs 4.2%), coronary artery
disease (58.5% vs 50.5%), concomitant coronary artery bypass grafting (46.7% vs 41.9%), and having surgery
in a high-volume (>250 cases per year) center (31.3% vs 18.5%). Patients receiving bioprosthetic valves had
a higher occurrence of in-hospital complications (55.9% vs 48.6%), but lower in-hospital mortality (4.4% vs
4.9%) than patients receiving mechanical valves. This difference was confirmed in propensity-matched analy-
ses (complications: 52.7% vs 51.5%; mortality: 4.3% vs 5.2%).
Conclusions:
Use of bioprosthetic valves in AVR increased dramatically from 1998 to 2011, particularly in pa-
tients age 55 to 64 years. Prosthesis selection varied significantly by facility, with low-volume facilities favoring
mechanical valves. Aortic valve replacement with a bioprosthetic valve, compared with a mechanical valve,
was associated with lower in-hospital mortality.
J Cardiovasc Med Ther 2019, Volume 3