Long-term durability of pericardial valves in the aortic position in younger patients: when does reoperation become necessary?

Journal of Cardiac Surgery
Kenji MinakataRyuzo Sakata

Abstract

We sought to assess the long-term durability of pericardial valves in patients at age <65 years undergoing aortic valve replacement (AVR), and to determine the timing of redo operations due to structural valve deterioration (SVD). From 1986 to 2001, a total of 574 adult patients underwent AVR with pericardial valves in nine hospitals in Japan. Of these, 53 patients were at age <65 years (group Y). These patients were compared with those of age ≥ 65 (group O, n = 521). The mean follow-up duration was 9.5 years in group Y and 8.1 years in group O. Freedom from reoperation due to SVD was 100% at five years, 90.8% at 10 years, and 47.2% at 15 years in group Y, and 99.3% at five years, 97.4% at 10 years, and 94.4% at 15 years in group O (log-rank test, p < 0.01). In those who required redo AVR in group Y (n = 12), the mean time from initial operation to reoperation was 12.1 years. The reoperation-free survival curve started to decline after eight years postoperation in group Y. Redo AVR started to become necessary eight years after surgery in the patients who underwent AVR with pericardial valve at age <65 years. In addition, approximately half of those patients required reoperation due to SVD by 15 years postoperatively.

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Citations

Sep 9, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenji MinakataRyuzo Sakata
Feb 15, 2019·Circulation. Cardiovascular Quality and Outcomes·Jonathan R G EtnelJohanna J M Takkenberg

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