National trends in utilization and in-hospital outcomes of mechanical versus bioprosthetic aortic valve replacements

The Journal of Thoracic and Cardiovascular Surgery
Abby J IsaacsArt Sedrakyan

Abstract

Substantial controversy surrounds the choice between a mechanical versus bioprosthetic prosthesis for aortic valve replacement (AVR), based on age. This study aims to investigate national trends and in-hospital outcomes of the 2 prosthesis choices. 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 compared their in-hospital outcomes. 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 receiving 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 ...Continue Reading

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Citations

Mar 31, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Simone A HuygensJohanna J M Takkenberg
Jul 2, 2015·The Journal of Thoracic and Cardiovascular Surgery·Art SedrakyanJeffrey Shuhaiber
Mar 23, 2015·The Journal of Thoracic and Cardiovascular Surgery·Paul Kurlansky
Nov 5, 2015·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Thierry BourguignonMichel Aupart
May 1, 2016·The Journal of Thoracic and Cardiovascular Surgery·Elaine E Tseng
Apr 27, 2017·European Heart Journal·Stuart J HeadA Pieter Kappetein
Jun 20, 2017·The Journal of Thoracic and Cardiovascular Surgery·Maral OuzounianTirone E David
Dec 1, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Buntaro FujitaUNKNOWN GARY Executive Board
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Feb 18, 2017·Circulation·Anthony P CarnicelliUNKNOWN ENGAGE AF-TIMI 48 Investigators
Jan 24, 2018·Circulation·Danny DvirUNKNOWN VIVID (Valve in Valve International Data) Investigators
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Jan 5, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Emiliano A Rodríguez-CauloJosé M Melero
Dec 24, 2018·Current Opinion in Cardiology·Amine MazineBobby Yanagawa
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Jan 31, 2019·The Journal of Cardiovascular Surgery·Javier De Miguel-DíezRodrigo Jiménez-García
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