Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Immediate and Medium-Term Results of Aortic Valve Replacement With Biological Prosthesis in Elderly Patients: One Center’s Experience

Version 1 : Received: 17 May 2023 / Approved: 18 May 2023 / Online: 18 May 2023 (05:06:17 CEST)

A peer-reviewed article of this Preprint also exists.

Kadyraliev, B.К.; Belov, V.А.; Arutyunyan, V.B.; Marchenko, А.V.; Kdralieva, N.V.; Enginoev, S.Т.; Kuchumov, А.G. Immediate and Medium-Term Results of Aortic Valve Replacement with Biological Prosthesis in Elderly Patients: Experience of One Center. Perm Medical Journal 2024, 40, 61–73, doi:10.17816/pmj40661-73. Kadyraliev, B.К.; Belov, V.А.; Arutyunyan, V.B.; Marchenko, А.V.; Kdralieva, N.V.; Enginoev, S.Т.; Kuchumov, А.G. Immediate and Medium-Term Results of Aortic Valve Replacement with Biological Prosthesis in Elderly Patients: Experience of One Center. Perm Medical Journal 2024, 40, 61–73, doi:10.17816/pmj40661-73.

Abstract

Currently, aortic valve (AV) disease is the most common reason for heart valve surgery. The gold standard of care for people with aortic pathology is thought to be AV replacement. The issue of prosthesis selection has always been important. Although mechanical prosthesis are robust, lifelong anticoagulation medication is necessary due to the significant risk of thromboembolic consequences. Biological prostheses have a flow structure that is similar to the physiological one, and as malfunction gradually sets in, scheduled recurrent surgery can be carried out. The purpose of this study is to evaluate the short- and long-term effects of biological prosthetic aortic valve replacement (AVR) in elderly individuals. The study included 198 patients with AV pathology [85 men (42.9%)/113 women (57.1%)]. The median age was 70 [66–73] years. There were 175 (88.4%) patients with degenerative AV, 5 (2.5%) with infective endocarditis, and 30 patients (15.2%) had bicuspid AV. The median follow-up period was 26.3±1.4 months. Hospital mortality was 4.5%. No wound complications were detected. Thirty-one patients died in the long-term period. The causes of lethality were: cardiovascular disease (13 patients), malignant neoplasm (5 patients), gastrointestinal disease (2 patients), urinary system disease (1 patient), COVID-19 (1 patient), unknown cause (9 patients). Thus, the five-year postoperative survival rate was 63%, respectively. Throughout the observation period, two patients (2.9%) underwent reoperation on AV. 97.1% of patients were free of reoperation after five years. The five-year survival rate was 63% due to the history of severe concomitant pathology and mean age of the patients of 70 years.

Keywords

aortic valve; bioprosthesis; surgical aortic valve replacement (SAVR)

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

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