Influence of different kinds of valve types on clinical benefits of elderly patients with valvular heart disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHAO Fei , ZHOU Yang , TANG Shihai , ZHENG Bo , ZHANg Fan , LIU Wei ,  PENG Huali

Department of Thoracic and Cardiovascular Surgery, People's Hospital of Leshan City, Leshan, 614000, Sichuan, P.R.China;

Corresponding author：

PENG Huali, Email: PengHL08@163.com

Keywords：

Mechanical valves; biological valves; old age; valvular heart disease; treatment

DOI：

10.7507/1007-4848.201910053

Video：

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Objective To investigate the influence of mechanical and biological valves on clinical benefits of elderly patients with valvular heart disease.Methods We retrospectively analyzed the clinical data of 280 elderly patients with valvular heart disease treated by valve replacement between 2008 and 2014 year. The patients were divided into two groups by tendency score matching including a group A with biological valves and a group B with mechanical valves. Finally, there were 96 patients in each group. There were 43 males and 53 females at age of 64.41±6.52 years in the group A, 44 males and 52 females at age of 64.07±6.20 years in the group B.Results The bleeding rate of skin and mucosa of the group B was significantly higher than that of the group A (P<0.05). There was no statistical difference in mortality within 30 days after operation, all-cause mortality, re-hospitalization rate, re-valve replacement rate, combined atrial flutter/atrial fibrillation ratio, drug use, incidence of cerebral infarction, cerebral hemorrhage, new peripheral vascular embolism and visceral hemorrhage, heart function (NYHA) classification, the cumulative survival rate of all the patients during follow-up (P=0.63), or the cumulative survival rate of the patients with no thrombus/hemorrhage (P=0.75) between the two groups (P>0.05).Conclusion Mechanical valve replacement and bioprosthetic valve replacement in the treatment of valvular heart disease in the elderly can achieve similar clinical benefits and both have clinical application value.

Citation： ZHAO Fei, ZHOU Yang, TANG Shihai, ZHENG Bo, ZHANg Fan, LIU Wei, PENG Huali. Influence of different kinds of valve types on clinical benefits of elderly patients with valvular heart disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(7): 762-765. doi: 10.7507/1007-4848.201910053 Copy

1.	宋光远, 王墨扬, 王媛, 等. Venus-A 主动脉瓣膜介入治疗重度主动脉瓣狭窄的效果. 中华心血管病杂志, 2017, 45(10): 843-847.
2.	Hof A, Raschke S, Baier K, et al. Challenges in developing a reseeded, tissue-engineered aortic valve prosthesis. Eur J Cardiothorac Surg, 2016, 50(3): 446-455.
3.	Silaschi M, Chaubey S, Aldalati O, et al. Is mitral valve repair superior to mitral valve replacement in elderly patients? comparison of shortand long-term outcomes in a propensity-matched cohort. J Am Heart Assoc, 2016, 5(8): e003605.
4.	Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
5.	王奇, 主编. 心血管外科. 北京: 中国科学技术出版社, 2015. 110-112.
6.	项理, 刘一为, 黄源, 等. 复杂型先天性心脏病瓣膜成形术后中期生存结果和生活质量研究. 中国循环杂志, 2017, 32(z1): 159.
7.	张李涛, 龙艳丽, 杨军, 等. D-二聚体水平与机械心脏瓣膜置换术后患者抗凝治疗中发生临床事件的关系. 中华心血管病杂志, 2017, 45(10): 852-856.
8.	Bisson A, Bodin A, Clementy N, et al. Stroke, thromboembolism and bleeding in patients with atrial fibrillation according to the EHRA valvular heart disease classification. Int J Cardiol, 2018, 260(6): 93-98.
9.	Binder RK, Nietlispach F, Holubec T, et al. Percutaneous treatment of severe transvalvular and paravalvular regurgitation in a failing surgical aortic valve prosthesis due to recurrent endocarditis. Eur Heart J, 2016, 37(45): 3419-3424.
10.	Breithardt G, Baumgartner H, Berkowitz SD, et al. Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban. Heart, 2016, 102(13): 1036-1043.
11.	Poulin F, Yingchoncharoen T, Wilson WM, et al. Impact of prosthesis‐patient mismatch on left ventricular myocardial mechanics after transcatheter aortic valve replacement. J Am Heart Assoc, 2016, 5(2): e002866.
12.	Carnicelli AP, O’Gara PT, Giugliano RP. Anticoagulation after heart valve replacement or transcatheter valve implantation. Am J Cardiol, 2016, 118(9): 1419-1426.
13.	Head SJ, Çelik M, Kappetein AP. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28): 2183-2191.
14.	Lim G. Valvular disease: Mechanical versus biological valve prostheses. Nat Rev Cardiol, 2018, 15(1): 4-7.
15.	Hellmeier F, Nordmeyer S, Yevtushenko P, et al. Hemodynamic evaluation of a biological and mechanical aortic valve prosthesis using patient-specific mri-based CFD. Artif Organs, 2018, 42(1): 49-57.
16.	Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.

1. 宋光远, 王墨扬, 王媛, 等. Venus-A 主动脉瓣膜介入治疗重度主动脉瓣狭窄的效果. 中华心血管病杂志, 2017, 45(10): 843-847.
2. Hof A, Raschke S, Baier K, et al. Challenges in developing a reseeded, tissue-engineered aortic valve prosthesis. Eur J Cardiothorac Surg, 2016, 50(3): 446-455.
3. Silaschi M, Chaubey S, Aldalati O, et al. Is mitral valve repair superior to mitral valve replacement in elderly patients? comparison of shortand long-term outcomes in a propensity-matched cohort. J Am Heart Assoc, 2016, 5(8): e003605.
4. Nishimura RA, Otto CM, Bonow RO, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. J Am Coll Cardiol, 2017, 70(2): 252-289.
5. 王奇, 主编. 心血管外科. 北京: 中国科学技术出版社, 2015. 110-112.
6. 项理, 刘一为, 黄源, 等. 复杂型先天性心脏病瓣膜成形术后中期生存结果和生活质量研究. 中国循环杂志, 2017, 32(z1): 159.
7. 张李涛, 龙艳丽, 杨军, 等. D-二聚体水平与机械心脏瓣膜置换术后患者抗凝治疗中发生临床事件的关系. 中华心血管病杂志, 2017, 45(10): 852-856.
8. Bisson A, Bodin A, Clementy N, et al. Stroke, thromboembolism and bleeding in patients with atrial fibrillation according to the EHRA valvular heart disease classification. Int J Cardiol, 2018, 260(6): 93-98.
9. Binder RK, Nietlispach F, Holubec T, et al. Percutaneous treatment of severe transvalvular and paravalvular regurgitation in a failing surgical aortic valve prosthesis due to recurrent endocarditis. Eur Heart J, 2016, 37(45): 3419-3424.
10. Breithardt G, Baumgartner H, Berkowitz SD, et al. Native valve disease in patients with non-valvular atrial fibrillation on warfarin or rivaroxaban. Heart, 2016, 102(13): 1036-1043.
11. Poulin F, Yingchoncharoen T, Wilson WM, et al. Impact of prosthesis‐patient mismatch on left ventricular myocardial mechanics after transcatheter aortic valve replacement. J Am Heart Assoc, 2016, 5(2): e002866.
12. Carnicelli AP, O’Gara PT, Giugliano RP. Anticoagulation after heart valve replacement or transcatheter valve implantation. Am J Cardiol, 2016, 118(9): 1419-1426.
13. Head SJ, Çelik M, Kappetein AP. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28): 2183-2191.
14. Lim G. Valvular disease: Mechanical versus biological valve prostheses. Nat Rev Cardiol, 2018, 15(1): 4-7.
15. Hellmeier F, Nordmeyer S, Yevtushenko P, et al. Hemodynamic evaluation of a biological and mechanical aortic valve prosthesis using patient-specific mri-based CFD. Artif Organs, 2018, 42(1): 49-57.
16. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS guidelines for the management of valvular heart disease. Eur Heart J, 2017, 38(36): 2739-2791.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influence of different kinds of valve types on clinical benefits of elderly patients with valvular heart disease

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