Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure
Background The widely used Bentall procedure is the criterion standard treatment for aortic root pathology. Studies comparing the long‐term outcomes of bioprosthetic and mechanical valves in patients undergoing the Bentall procedure are limited. Methods and Results Patients who underwent the Bentall...
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| Format: | Article |
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Wiley
2024-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.030328 |
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| author | Cheng‐Yu Chen Chun‐Yu Chen Feng‐Cheng Chang Yu‐Ting Cheng Victor Chien‐Chia Wu Chia‐Pin Lin Yi‐Hsin Chan Kuo‐Chun Hung Pao‐Hsien Chu Shao‐Wei Chen |
| author_facet | Cheng‐Yu Chen Chun‐Yu Chen Feng‐Cheng Chang Yu‐Ting Cheng Victor Chien‐Chia Wu Chia‐Pin Lin Yi‐Hsin Chan Kuo‐Chun Hung Pao‐Hsien Chu Shao‐Wei Chen |
| author_sort | Cheng‐Yu Chen |
| collection | DOAJ |
| description | Background The widely used Bentall procedure is the criterion standard treatment for aortic root pathology. Studies comparing the long‐term outcomes of bioprosthetic and mechanical valves in patients undergoing the Bentall procedure are limited. Methods and Results Patients who underwent the Bentall procedure with a bioprosthetic or mechanical valve between 2001 and 2018 were identified from Taiwan's National Health Insurance Research Database. The primary outcome of interest was all‐cause mortality. Inverse probability of treatment weighting was performed to compare the 2 prosthetic types. In total, 1052 patients who underwent the Bentall procedure were identified. Among these patients, 351 (33.4%) and 701 (66.6%) chose bioprosthetic and mechanical valves, respectively. After inverse probability of treatment weighting, no significant differences in the in‐hospital mortality (odds ratio, 0.96 [95% CI, 0.77–1.19]; P=0.716) and all‐cause mortality (34.1% vs. 38.1%; hazard ratio, 0.90 [95% CI, 0.78–1.04]; P=0.154) were observed between the groups. The benefits of relative mortality associated with mechanical valves were apparent in younger patients and persisted until ≈50 years of age. Conclusions No differences in survival benefits were observed between the valves in patients who underwent the Bentall procedure. Additionally, bioprosthetic valves may be a reasonable choice for patients aged >50 years when receiving the Bentall procedure in this valve‐in‐valve era. |
| first_indexed | 2024-03-08T13:50:05Z |
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| id | doaj.art-32668099123d4b3cab34a8c50a3d0bd8 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:25Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-32668099123d4b3cab34a8c50a3d0bd82024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.030328Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall ProcedureCheng‐Yu Chen0Chun‐Yu Chen1Feng‐Cheng Chang2Yu‐Ting Cheng3Victor Chien‐Chia Wu4Chia‐Pin Lin5Yi‐Hsin Chan6Kuo‐Chun Hung7Pao‐Hsien Chu8Shao‐Wei Chen9Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Anesthesiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDivision of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDepartment of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanDivision of Thoracic and Cardiovascular Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou Medical Center Chang Gung University Taoyuan City TaiwanBackground The widely used Bentall procedure is the criterion standard treatment for aortic root pathology. Studies comparing the long‐term outcomes of bioprosthetic and mechanical valves in patients undergoing the Bentall procedure are limited. Methods and Results Patients who underwent the Bentall procedure with a bioprosthetic or mechanical valve between 2001 and 2018 were identified from Taiwan's National Health Insurance Research Database. The primary outcome of interest was all‐cause mortality. Inverse probability of treatment weighting was performed to compare the 2 prosthetic types. In total, 1052 patients who underwent the Bentall procedure were identified. Among these patients, 351 (33.4%) and 701 (66.6%) chose bioprosthetic and mechanical valves, respectively. After inverse probability of treatment weighting, no significant differences in the in‐hospital mortality (odds ratio, 0.96 [95% CI, 0.77–1.19]; P=0.716) and all‐cause mortality (34.1% vs. 38.1%; hazard ratio, 0.90 [95% CI, 0.78–1.04]; P=0.154) were observed between the groups. The benefits of relative mortality associated with mechanical valves were apparent in younger patients and persisted until ≈50 years of age. Conclusions No differences in survival benefits were observed between the valves in patients who underwent the Bentall procedure. Additionally, bioprosthetic valves may be a reasonable choice for patients aged >50 years when receiving the Bentall procedure in this valve‐in‐valve era.https://www.ahajournals.org/doi/10.1161/JAHA.123.030328aortic root pathologyaortic root surgeryaortic valve replacementBentall procedurecomposite valve graftprosthesis |
| spellingShingle | Cheng‐Yu Chen Chun‐Yu Chen Feng‐Cheng Chang Yu‐Ting Cheng Victor Chien‐Chia Wu Chia‐Pin Lin Yi‐Hsin Chan Kuo‐Chun Hung Pao‐Hsien Chu Shao‐Wei Chen Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease aortic root pathology aortic root surgery aortic valve replacement Bentall procedure composite valve graft prosthesis |
| title | Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure |
| title_full | Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure |
| title_fullStr | Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure |
| title_full_unstemmed | Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure |
| title_short | Mechanical Versus Bioprosthetic Aortic Valve Replacement in Patients Undergoing Bentall Procedure |
| title_sort | mechanical versus bioprosthetic aortic valve replacement in patients undergoing bentall procedure |
| topic | aortic root pathology aortic root surgery aortic valve replacement Bentall procedure composite valve graft prosthesis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.030328 |
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