Midterm outcomes and quality of life of aortic root replacement: mechanical vs biological conduits

Can J Cardiol. Mar-Apr 2011;27(2):262.e15-20. doi: 10.1016/j.cjca.2010.12.034.

Abstract

Background: Aortic root replacement is a complex operation for severe aortic root pathology such as aneurysms and dissections with concomitant aortic valve disease. Biological and mechanical valve conduits are available.

Methods: Early and midterm results were analyzed in patients undergoing aortic root replacement. From January 1, 1998, to May 31, 2007, 144 patients underwent aortic root replacement (Bentall procedures) with either a mechanical (n = 51) or a biological (n = 93) valve conduit. Cox proportional hazard analysis was used to determine whether valve type was an independent predictor of all-cause mortality, and analysis of covariance was used to compare general and disease-specific health-related quality-of-life scores.

Results: Operative mortality was 2.1%. Median follow-up time was 40 months; 1- and 5-year survival rates for the mechanical group were 96.0% and 89.0%, respectively, vs 93.0% and 84.0% for the biological group. Valve type was not predictive of all-cause mortality, and valve-related complications were not significantly different between groups. At follow-up, 31.5% of patients in the biological group were on anticoagulant. General and disease-specific health-related quality-of-life scores were not significantly different between groups.

Conclusions: Aortic root replacement with either mechanical or biological valved conduits is a safe procedure. Morbidity, mortality, and adverse quality of life were not associated with the type of valve conduit. Further studies are required to assess long-term durability of biological valve conduits used for aortic root replacement.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alberta / epidemiology
  • Aortic Diseases / mortality
  • Aortic Diseases / surgery*
  • Bioprosthesis*
  • Blood Vessel Prosthesis Implantation / instrumentation*
  • Blood Vessel Prosthesis Implantation / mortality
  • Blood Vessel Prosthesis Implantation / psychology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Quality of Life*
  • Retrospective Studies
  • Survival Rate / trends
  • Treatment Outcome