![]() ![]() Four patients who were >70 years old with mechanical valves were also excluded. Among the remaining 752 patients, 494 who underwent AVR with bioprosthesis were excluded. Patients with coronary artery disease incidentally found on preoperative angiographs were included. Eighty-three patients who had main coronary artery disease with AS, rheumatic AS, or history of previous cardiac surgery were excluded. We retrospectively reviewed data from 835 patients who underwent primary AVR for severe AS at our hospital from January 1995 to December 2013. This study aimed to evaluate the clinical and hemodynamic outcomes of old- and new-generation mechanical prostheses after AVR for aortic stenosis (AS). However, little has been reported about comparative long-term results or effects of anticoagulation between old and new mechanical prostheses in the aortic position. Several new-generation mechanical prostheses have been released that yielded better hemodynamic performance than the earlier generations ( 7- 9). Additionally, there have been contradictory results regarding AVR with mechanical prostheses compared with bioprostheses according to target INR in the middle aged-group ( 1, 2, 6). Lowering the target international normalized ratio (INR) and self-INR management could reduce hemorrhagic events ( 4, 5). However, low-dose anticoagulation has been suggested to improve the outcomes of mechanical AVR ( 3). Accepted for publication May 29, 2018.Īlthough mechanical prostheses are still the main valve substitutes for younger patients, risks of thromboembolism and bleeding complications associated with life-long anticoagulation are major concerns ( 1, 2). Keywords: Aortic valve replacement mechanical valve anticoagulation prosthesis-patient mismatch (PPM) ![]() Anticoagulation strategy to lower the target INR in patients with new mechanical valves may improve late outcomes by reducing hemorrhagic events. ![]() Multivariate analysis of the total population revealed that PPM was a significant risk factor for cardiac-related events and showed higher trend of increasing mortality (HR =3.082, P=0.076).Ĭonclusions: New mechanical prostheses showed a better hemodynamic performance and lower incidence of PPM. The incidence of prosthesis-patient mismatch (PPM) was significantly higher in the old-valve group (P<0.001). The median international normalized ratio (INR) at follow-up was significantly higher in the old-valve group. Results: Cardiac-related mortality and hemorrhagic events were significantly lower in the new-valve group (P=0.047 and P=0.032, respectively). The median follow-up duration was 91 months (Q1–Q3: 48–138). ![]() With propensity score matching based on demographic information, 56 patients in the old-valve group were matched with 177 patients in the new-valve group. Median patient age was 58 years (Q1–Q3: 52–61). Jude Regent, 46 On-X, 30 Sorin Overline). Patients were classified into two groups: old-valve group (n=65: 33 ATS standard, 32 Medtronic-Hall) and new-valve group (n=189: 113 St. Methods: We retrospectively reviewed data from 254 patients with severe AS, who underwent primary mechanical aortic valve replacement from 1995 to 2013. Interviews with Outstanding Guest Editorsīackground: The study aimed to evaluate the late clinical outcomes of new-generation mechanical valves for severe aortic stenosis (AS) compared with old mechanical valves.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |