title: Late results of double-valve replacement with biologic or mechanical prostheses.
abstract: BACKGROUND
  We previously showed that the risk of reoperation for structural degeneration of bioprostheses was higher in cases involving patients older than 65 years (p = 0.003) and double-valve replacement (p = 0.02). The purpose of this study was to compare late outcome of mitral-aortic valve replacement using bioprostheses or mechanical valves.
  
  
  METHODS
  The bioprosthesis group included all mainland France residents (n = 48) between 55 and 65 years old operated on between 1980 and 1995 for mitral-aortic valve replacement using bioprostheses. The mechanical valve group was obtained by matching each of these patients with a patient operated on using mechanical valves at approximately the same time during the study.
  
  
  RESULTS
  In the bioprosthesis group, 10-year survival was 45%+/-8% versus 62%+/-7% in the mechanical valve group (not significant). The linearized reoperation rate was 6.8 per patient-year versus 1.1 per patient-year (p = 0.001), and the linearized reoperative mortality rate was 1.8 per patient-year and 0.7 per patient-year (not significant), respectively.
  
  
  CONCLUSIONS
  The reoperative mortality risk after mitral-aortic valve replacement using two bioprostheses does not significantly decrease overall survival after age 65 years.
authors.affiliation: Cardiac Surgery Service, CHU Timone, Marseille, France. tcaus@ap-hm.fr
authors.forename: T
authors.initials: T
authors.lastname: Caus
authors.forename: P
authors.initials: P
authors.lastname: Rouvière
authors.forename: F
authors.initials: F
authors.lastname: Collart
authors.forename: A
authors.initials: A
authors.lastname: Mouly-Bandini
authors.forename: J R
authors.initials: JR
authors.lastname: Montiès
authors.forename: T
authors.initials: T
authors.lastname: Mesana
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001705:Bioprosthesis; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality; D011474:Prosthesis Design; D012086:Reoperation; D016019:Survival Analysis