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

Research output: Contribution to journalArticleResearchpeer-review

32 Citations (Scopus)


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
Issue number2
Publication statusPublished - 1 Jan 1997
Externally publishedYes

Cite this