An analysis of valve re-replacement after aortic valve replacement with biologic devices

D. C. McGiffin, A. J. Galbraith, M. F. O'Brien, G. J. McLachlan, D. C. Naftel, P. Adams, S. Reddy, L. Early

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Abstract

Biologic valve re-replacement was examined in a series of 1343 patients who underwent aortic valve replacement at The Prince Charles Hospital, Brisbane, with a cryopreserved or 4°C stared allograft valve or a xenograft valve. A parametric model approach was used to simultaneously model the competing risks of death without re-replacement and re-replacement before death. One hundred eleven patients underwent a first re-replacement for a variety of reasons (69 patients with xenograft valves, 28 patients with 4°C stored allograft valves, and 14 patients with cryopreserved allograft valves). By multivariable analysis younger age at operation was associated with xenograft, 4°C stored allograft, and cryopreserved allograft valve re- replacement. However, this effect was examined in the context of longer survival of younger patients, which increases their exposure to the risk of re-replacement as compared with that in older patients whose decreased survival reduced their probability of requiring valve re-replacement. In patients older than 60 years at the time of aortic valve replacement, the probability of re-replacement (for any reason) before death was similar for xenografts and cryopreserved allograft valves but higher for 4°C stored valves. However, in patients younger than 60 years, the probability of re- replacement at any time during the remainder of the life of the patient was lower with the cryopreserved allograft valve compared with the xenograft valve and 4°C stored allografts.

Original languageEnglish
Pages (from-to)311-318
Number of pages8
JournalJournal of Thoracic and Cardiovascular Surgery
Volume113
Issue number2
DOIs
Publication statusPublished - 1 Jan 1997
Externally publishedYes

Cite this

McGiffin, D. C., Galbraith, A. J., O'Brien, M. F., McLachlan, G. J., Naftel, D. C., Adams, P., Reddy, S., & Early, L. (1997). An analysis of valve re-replacement after aortic valve replacement with biologic devices. Journal of Thoracic and Cardiovascular Surgery, 113(2), 311-318. https://doi.org/10.1016/S0022-5223(97)70328-3