TY - JOUR
T1 - An analysis of valve re-replacement after aortic valve replacement with biologic devices
AU - McGiffin, D. C.
AU - Galbraith, A. J.
AU - O'Brien, M. F.
AU - McLachlan, G. J.
AU - Naftel, D. C.
AU - Adams, P.
AU - Reddy, S.
AU - Early, L.
PY - 1997/1/1
Y1 - 1997/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=0031045085&partnerID=8YFLogxK
U2 - 10.1016/S0022-5223(97)70328-3
DO - 10.1016/S0022-5223(97)70328-3
M3 - Article
C2 - 9040625
AN - SCOPUS:0031045085
SN - 0022-5223
VL - 113
SP - 311
EP - 318
JO - The Journal of Thoracic and Cardiovascular Surgery
JF - The Journal of Thoracic and Cardiovascular Surgery
IS - 2
ER -