Pericardial Versus Porcine Valves for Surgical Aortic Valve Replacement

Korean Circulation Journal 2022년 52권 2호 p.136 ~ p.146

신흥주(Shin Hong-Ju) - Korea University College of Medicine Korea University Ansan Hospital Department of Thoracic and Cardiovascular Surgery
김완기(Kim Wan-Kee) - Yonsei University College of Medicine Yongin Severance Hospital Department of Thoracic and Cardiovascular Surgery
김진경(Kim Jin-Kyoung) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
김준범(Kim Joon-Bum) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
정성호(Jung Sung-Ho) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
주석중(Choo Suk-Jung) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
정철현(Chung Cheol-Hyun) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery
이재원(Lee Jae-Won) - University of Ulsan College of Medicine Asan Medical Center Department of Thoracic and Cardiovascular Surgery

Abstract

Background and Objectives: There still are controversies on which type between bovine pericardial and porcine valves is superior in the setting of aortic valve replacement (AVR). This study aims to compare clinical outcomes of AVR using between pericardial or porcine valves.

Methods: The study involved consecutive 636 patients underwent isolated AVR using stented bioprosthetic valves between January 2000 and May 2016. Of these, pericardial and porcine valves were implanted in 410 (pericardial group) and 226 patients (porcine group), respectively. Clinical outcomes including survival, structural valve deterioration (SVD) and trans-valvular pressure gradient were compared between the groups. To adjust for potential selection bias, inverse probability treatment weighting (IPTW) was conducted.

Results: The mean follow-up duration was 60.1±50.2 months. There were no significant differences in the rates of early mortality (3.1% vs. 3.1%; p=0.81) and SVD (0.3%/patient-year [PY] vs. 0.5%/PY; p=0.33) between groups. After adjustment using IPTW, however, landmark mortality analyses showed a significantly lower late (>8 years) mortality risk in pericardial group over porcine group (hazard ratio [HR], 0.61; 95% confidence interval, [CI] 0.41?0.90; p=0.01) while the risks of SVD were not significantly difference between groups (HR, 0.45; 95% CI, 0.12?1.70; p=0.24). Mean pressure gradient across prosthetic AV was lower in the Pericardial group than the Porcine group at both immediate postoperative point and latest follow-up (p values <0.001).

Conclusions: In patients undergoing bioprosthetic surgical AVR, bovine pericardial valves showed superior results in terms of postoperative hemodynamic profiles and late survival rates over porcine valves.

키워드

Aortic valve, Bioprosthesis
원문 및 링크아웃 정보
등재저널 정보
SCI(E) 학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
The use of bovine pericardial valves was associated with superior hemodynamic profiles and improved late survival as compared with porcine valves.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드