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31st Annual Meeting Abstracts: Comparison of Mechanical Prostheses and Bioprostheses in Aortic and Mitral Valve Replacement in Age Groups 61-65 and 66-70 Years
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P7. Comparison of Mechanical Prostheses and Bioprostheses in Aortic and Mitral Valve Replacement in Age Groups 61-65 and 66-70 Years
K. Prasongsukarn, W. Jamieson*, E. Germann, F. Chan, S. V. Lichtenstein. University of British Columbia, Vancouver, BC, Canada,
Background
The prosthesis choice decision for aortic valve replacements within the age group 61-70 years is often difficult. The study was designed to evaluate prosthesis types in age groups 61-65 years and 66-70 years by freedom from thromboembolism (major and hemorrhage (TEM-H) and freedom from valve-related reoperation (VR-REOP).
Methods
Current marketed prostheses implanted between 1982 and 1998 included aortic valve replacement (AVR) BP 619 and MP 303 and mitral valve replacement (MVR) BP 353 and MP 312. The freedom (actual and actuarial) from TEM-H and VR-REOP was determined for age groups 61-65 years and 66-70 years for both AVR and MVR at 15 years. | TEM-H | VR-REOP | | 61-65 years | 66-70 years | 61-65 years | 66-70 years | | AVR | AVR | | BP | 89.2+2.6% | 82.9+2.2% | 86.2+3.2% | 94.7+1.5% | | MP | 81.4+4.4% | 70.5+6.9% (11yrs) | 80.8+15.0% | 99.3+0.7% (12yrs) | | BP>MP p=0.025 | BP>MP p=0.0002 | MP>BP pNS | MP>BP pNS | | MVR | MVR | | BP | 86.5+3.2% | 79.8+3.3% | 66.4+4.3% | 81.3+3.2% | | MP | 78.9+5.0% (12yrs) | 74.9+5.5% (11yrs) | 94.5+4.1% (12yrs) | 93.2+2.6% (11yrs) | | BP>MP p=0.037 | BP>MP pNS | MP>BP p=0.003 | MP>BP p=0.018 |
Conclusions
1) Risk of VR-REOP compared to freedom from TEM-H favours BP for AVR for both age groups.
2) Freedom from VR-REOP regardless of better freedom from TEM-H favours MP for MVR for both age groups.
3) Valve type in 61-65 years group influenced freedom from REOP for MVR but not AVR, and freedom from TEM and H for both AVR and MVR.
4) Valve type in 66-70 years group had influence on freedom REOP for MVR only, but had an influence on freedom from TEM and H for AVR but no influence on MVR.
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