초록접수 현황
| 20F-057 | 구연 발표 |
Isolated Aortic Valve Replacement with Mechanical versus Biological Prosthesis in Patients Aged 50 to 69 Years: Propensity score-matched analysis from Korean National Data
Min-Seok Kim, Jung Whan Kim, Seung Hyun Lee, Sak Lee, Young-Nam Youn, Kyung-Jong Yoon, Hyun-Chel Choo
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Purpose : To compare the long-term survival and complications in patients who underwent aortic valve replacement (AVR) using mechanical versus bioprosthetic valves, by analyzing the National big data.
Methods : Patients aged 50-69 years who had undergone AVR from 2002 to 2018 in Republic of Korea, were identified and their characteristics were collected from National Health Information Database formed by the National Health Insurance Service, Republic of Korea. Of 5792 patients, 1060 patients were excluded due to missing values on characteristics. Among the 4732 patients, 1945 patients(41.1%) had received bioprosthetic valves(group B) and 2787 patients(58.9%) had received mechanical valves(group M). A propensity score-matched analysis was performed to match 1165 patients in each group.
Results : The overall survival rates at postoperative 15 years were 55.8% and 50.9% in group M and B, respectively(P=0.041). The freedom from cardiac deaths at postoperative 15 years were 88.2% and 87.9% in group M and B, respectively(P=0.570). Cumulative incidence of reoperation was higher in group B(P=0.007), and cumulative incidence of cerebrovascular accident revealed no statistical difference between the 2 groups(P=0.901). Major bleeding event rate was significantly higher in group M(P=0.039). Male gender and chronic renal failure were significant multivariable parameters of all-cause mortality.
Conclusion : Patients aged 50-69 years who received mechanical valves had better long-term survival than those with bioprostheses after AVR, although there was no significant difference in cardiac mortality. Reoperation rate was higher in patients who received bioprostheses, and major bleeding rate was more frequent in patients who received mechanical valves.
Methods : Patients aged 50-69 years who had undergone AVR from 2002 to 2018 in Republic of Korea, were identified and their characteristics were collected from National Health Information Database formed by the National Health Insurance Service, Republic of Korea. Of 5792 patients, 1060 patients were excluded due to missing values on characteristics. Among the 4732 patients, 1945 patients(41.1%) had received bioprosthetic valves(group B) and 2787 patients(58.9%) had received mechanical valves(group M). A propensity score-matched analysis was performed to match 1165 patients in each group.
Results : The overall survival rates at postoperative 15 years were 55.8% and 50.9% in group M and B, respectively(P=0.041). The freedom from cardiac deaths at postoperative 15 years were 88.2% and 87.9% in group M and B, respectively(P=0.570). Cumulative incidence of reoperation was higher in group B(P=0.007), and cumulative incidence of cerebrovascular accident revealed no statistical difference between the 2 groups(P=0.901). Major bleeding event rate was significantly higher in group M(P=0.039). Male gender and chronic renal failure were significant multivariable parameters of all-cause mortality.
Conclusion : Patients aged 50-69 years who received mechanical valves had better long-term survival than those with bioprostheses after AVR, although there was no significant difference in cardiac mortality. Reoperation rate was higher in patients who received bioprostheses, and major bleeding rate was more frequent in patients who received mechanical valves.
책임저자: Hyun-Chel Joo
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Min-Seok Kim, E-mail : mesmerist84@gmail.com