PMID- 16020589
OWN - NLM
STAT- MEDLINE
DCOM- 20050822
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 91
IP  - 8
DP  - 2005 Aug
TI  - Mid term outcome and quality of life after aortic valve replacement in elderly 
      people: mechanical versus stentless biological valves.
PG  - 1023-9
AB  - OBJECTIVE: To assess the benefit for patients older than 65 years of aortic valve 
      replacement with stentless biological heart valves in comparison with mechanical 
      valves. DESIGN: Multiple regression analysis of a retrospective follow up study. 
      SETTING: Single cardiothoracic centre. PATIENTS: Between 1996 and 2001, 392 
      patients with a mean age of 74 years underwent aortic valve replacement with 
      stentless Freestyle bioprostheses or mechanical St Jude Medical prostheses. MAIN 
      OUTCOME MEASURE: Operative mortality and morbidity, postoperative morbid events, 
      mid term survival, and New York Heart Association (NYHA) class improvement, and 
      quality of life. RESULTS: No significant differences were found between patients 
      receiving stentless biological valves and patients receiving mechanical 
      prostheses. However, analysis of subgroups showed that patients older than 75 
      years with mechanical valves had an increased risk of major bleeding events (p = 
      0.007). Patients requiring anticoagulation by means of coumarin had a twofold 
      increased risk of an impaired emotional reaction (p = 0.052). However, for 
      patients who received a mechanical valve for severe combined aortic valve disease 
      a survival advantage (p = 0.045) and a decreased risk of prolonged ventilation (p 
      = 0.001) was observed. On the other hand, patients receiving a stentless 
      bioprosthesis had an increased risk of a prolonged stay in intensive care (p = 
      0.04) and stroke (p = 0.01) if they had severely reduced cardiac function (NYHA 
      class IV). CONCLUSIONS: Elderly people receiving stentless bioprostheses benefit 
      emotionally because of the avoidance of coumarin. However, in patients with 
      severe hypertrophied ventricles and extraordinary calcifications, stentless 
      bioprostheses should be chosen with caution.
FAU - Florath, I
AU  - Florath I
AD  - Herzzentrum Lahr/Baden, Lahr, Germany. ines.florath@heart-lahr.com
FAU - Albert, A
AU  - Albert A
FAU - Rosendahl, U
AU  - Rosendahl U
FAU - Alexander, T
AU  - Alexander T
FAU - Ennker, I C
AU  - Ennker IC
FAU - Ennker, J
AU  - Ennker J
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
MH  - Aged
MH  - *Aortic Valve
MH  - *Bioprosthesis
MH  - Endocarditis/etiology/mortality
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/mortality/*surgery
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/methods/mortality
MH  - Humans
MH  - Male
MH  - Postoperative Complications/*etiology/mortality
MH  - Postoperative Hemorrhage/etiology/mortality
MH  - *Quality of Life
MH  - Reoperation
MH  - Retrospective Studies
MH  - Stroke/etiology/mortality
MH  - Surveys and Questionnaires
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC1769036
EDAT- 2005/07/16 09:00
MHDA- 2005/08/23 09:00
PMCR- 2008/08/01
CRDT- 2005/07/16 09:00
PHST- 2005/07/16 09:00 [pubmed]
PHST- 2005/08/23 09:00 [medline]
PHST- 2005/07/16 09:00 [entrez]
PHST- 2008/08/01 00:00 [pmc-release]
AID - 91/8/1023 [pii]
AID - 0911023 [pii]
AID - 10.1136/hrt.2004.036178 [doi]
PST - ppublish
SO  - Heart. 2005 Aug;91(8):1023-9. doi: 10.1136/hrt.2004.036178.