초록접수 현황
| 17F-079 | 구연 미채택시 포럼 발표 |
Pericardial Versus Porcine Valves for Surgical Aortic Valve Replacement
Jeong-Won Kim, M.D., Wan Kee Kim, M.D., Min Ho Ju, M.D., Ho Jin, Kim, M.D., Joon Bum Kim, M.D., Sung-Ho Jung, M.D., Suk Jung Choo, M.D., Cheol Hyun Chung, M.D., Jae Won Lee, M.D.
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
Purpose : There still are controversies whether superior hemodynamic profiles of the stented bovine pericardial valves over the porcine valve in the setting of aortic valve replacement (AVR). This study aims to compare clinical outcomes between the pericardial and porcine AVR.
Methods : The study involved consecutive 636 adult patients (71.3±6.9years; 284 females) undergoing isolated AVR using commercially available stented bioprosthetic valves between 2000 and 2016. Of these, pericardial and porcine valves were implanted in 410 (Pericardial group) and 226 patients (Porcine group), respectively. To reduce selection bias, inverse-probability-of-treatment weighting methods were performed based on propensity scores.
Results : Indexed effective valve orifice area (iEOA) was significantly larger in the Pericardial group than the Porcine group (1.1±0.3 vs. 0.9±0.2, P<0.001). During the follow-up (47.2±41.1 months), 130 deaths and 40 valve-related complications including 17 cases of aortic valve reoperations occurred in the overall cohort. Although there were no significant differences in mortality (p=0.80) and the composite of valve-related complications (p=0.37) rates, the Pericardial group showed a significantly superior reoperation-free rate (P=0.05) and lower mean trans-valvular pressure gradients (mTVPG, p<0.001) at last echocardiographic follow-up compared with the Porcine group. After adjustment, however, Pericardial group showed similar risks for death (HR, 1.18; 95% CI0.60-2.33; P=0.62), valve-related complications (HR, 1.18; 95% CI0.41-3.41; P=0.76), and reoperation (HR, 0.49; 95% CI0.07-3.49; P=0.48) rates compared with the Porcine group.
Conclusion : There were no significant differences of the adverse clinical outcomes according to the selection between pericardial and porcine aortic valve replacements, while the pericardial valve showed lower postoperative trans-prosthetic valvular pressure gradients.
Methods : The study involved consecutive 636 adult patients (71.3±6.9years; 284 females) undergoing isolated AVR using commercially available stented bioprosthetic valves between 2000 and 2016. Of these, pericardial and porcine valves were implanted in 410 (Pericardial group) and 226 patients (Porcine group), respectively. To reduce selection bias, inverse-probability-of-treatment weighting methods were performed based on propensity scores.
Results : Indexed effective valve orifice area (iEOA) was significantly larger in the Pericardial group than the Porcine group (1.1±0.3 vs. 0.9±0.2, P<0.001). During the follow-up (47.2±41.1 months), 130 deaths and 40 valve-related complications including 17 cases of aortic valve reoperations occurred in the overall cohort. Although there were no significant differences in mortality (p=0.80) and the composite of valve-related complications (p=0.37) rates, the Pericardial group showed a significantly superior reoperation-free rate (P=0.05) and lower mean trans-valvular pressure gradients (mTVPG, p<0.001) at last echocardiographic follow-up compared with the Porcine group. After adjustment, however, Pericardial group showed similar risks for death (HR, 1.18; 95% CI0.60-2.33; P=0.62), valve-related complications (HR, 1.18; 95% CI0.41-3.41; P=0.76), and reoperation (HR, 0.49; 95% CI0.07-3.49; P=0.48) rates compared with the Porcine group.
Conclusion : There were no significant differences of the adverse clinical outcomes according to the selection between pericardial and porcine aortic valve replacements, while the pericardial valve showed lower postoperative trans-prosthetic valvular pressure gradients.
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea
발표자: Jeong-Won Kim, E-mail : csjwkim@gmail.com