Kim, Sang Hyun; Kim, Ho Jin; Kim, Joon Bum; Jung, Sung-Ho; Choo, Suk Jung; Chung, Cheol Hyun; Lee, Jae Won
Interactive cardiovascular and thoracic surgery
2019Jan ; 28 ( 1 ) :58-64.
PMID : 30010890
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Kim, Sang Hyun - College of Medicine, Catholic University of Korea, Seoul, Korea.
Kim, Ho Jin - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kim, Joon Bum - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Jung, Sung-Ho - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Choo, Suk Jung - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chung, Cheol Hyun - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Lee, Jae Won - Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
ABSTRACT
OBJECTIVES: The superiority of supra-annular aortic prostheses over intra-annular equivalents in long-term haemodynamics and clinical outcomes remains controversial. This study compared outcomes among patients receiving supra-annular or intra-annular prostheses during aortic valve replacement.
METHODS: We enrolled 587 consecutive patients (mean age 55.1?±?11.3?years; 188 women) undergoing aortic valve replacement with either supra-annular (n?=?316) or intra-annular (n?=?271) mechanical prostheses between 2000 and 2016 in our institute. Clinical outcomes and haemodynamic profiles in the 2 groups were compared after propensity score adjustment.
RESULTS: Early death (1.1% vs 0.6%; P?=?0.863) was equivalent for both groups. Patients receiving supra-annular prostheses showed a lower rate of patient-prosthesis mismatch (1.2% vs 25.8%; P?
CONCLUSIONS: The implantation of supra-annular prostheses resulted in superior haemodynamics and left ventricular mass regression, while conferring no apparent clinical benefits. Follow-up studies are required to further evaluate the impact of superior haemodynamics associated with supra-annular prostheses on long-term clinical outcomes.
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