10 YEAR FOLLOW-UP OF AORTIC VALVE REPLACEMENT OUTCOMES STRATIFIED BY TYPE AND BRAND OF VALVE
CCC ePoster Library. Stubeda H. 10/26/19; 280550; 315
Herman Stubeda
Herman Stubeda
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Abstract
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BACKGROUND: Recent reports have called into question published durability data around aortic valve prosthesis some of these durability data. We sought to use detailed observational data from our centre to explore valve durability, specifically freedom from re-replacement, in a longitudinal cohort of patients who underwent surgical aortic valve replacement.

METHODS AND RESULTS: The Maritime Heart Centre Database, which includes detailed data for any major cardiac surgery procedure including outcomes to discharge, was searched for surgical aortic valve replacement, including re-operations between January 2006 and December 2016. Patients were stratified by valve type at first surgery and the outcome of interest was requirement for re-replacement of the prosthesis at any time during the study. Trifecta valves were only introduced in our centre in 2008, the remaining valves were available for the entire study period. During the study period valve implants by type were as follows: Mechanical AVR (SJM) 5.0% (134/2693); Carpentier Edwards Bioprosthesis 49.1% (1323/2693); SJM Epic Bioprosthesis 27.7% (746/2693); SJM Trifecta 18.1% (490/2693). Rates of re-replacement were as follows: Mechanical AVR (SJM) 4.5% (6/134); Carpentier Edwards Bioprosthesis 2.3% (30/1323) ; SJM Epic Bioprosthesis 2.8% (21/746); SJM Trifecta 2.0% (10/490).

CONCLUSION: We found a high rate of re-replacement among mechanical aortic valves. The remaining valves were comparable in their freedom from re-replacement. Further work to explore the mechanism of valve failure is ongoing. We made the assumption that all re-replacements in this patient group would occur at our centre, which is the sole provider of cardiac surgery care in Nova Scotia.
BACKGROUND: Recent reports have called into question published durability data around aortic valve prosthesis some of these durability data. We sought to use detailed observational data from our centre to explore valve durability, specifically freedom from re-replacement, in a longitudinal cohort of patients who underwent surgical aortic valve replacement.

METHODS AND RESULTS: The Maritime Heart Centre Database, which includes detailed data for any major cardiac surgery procedure including outcomes to discharge, was searched for surgical aortic valve replacement, including re-operations between January 2006 and December 2016. Patients were stratified by valve type at first surgery and the outcome of interest was requirement for re-replacement of the prosthesis at any time during the study. Trifecta valves were only introduced in our centre in 2008, the remaining valves were available for the entire study period. During the study period valve implants by type were as follows: Mechanical AVR (SJM) 5.0% (134/2693); Carpentier Edwards Bioprosthesis 49.1% (1323/2693); SJM Epic Bioprosthesis 27.7% (746/2693); SJM Trifecta 18.1% (490/2693). Rates of re-replacement were as follows: Mechanical AVR (SJM) 4.5% (6/134); Carpentier Edwards Bioprosthesis 2.3% (30/1323) ; SJM Epic Bioprosthesis 2.8% (21/746); SJM Trifecta 2.0% (10/490).

CONCLUSION: We found a high rate of re-replacement among mechanical aortic valves. The remaining valves were comparable in their freedom from re-replacement. Further work to explore the mechanism of valve failure is ongoing. We made the assumption that all re-replacements in this patient group would occur at our centre, which is the sole provider of cardiac surgery care in Nova Scotia.
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