title: Long-term results of mechanical and biological heart valves in dialysis and non-dialysis patients.
abstract: BACKGROUND
  We wanted to answer the question whether biological heart valves are inferior compared to mechanical heart valves in end-stage renal disease (ESRD) patients.
  
  
  METHODS
  Between 01/1996 und 12/2006, 44 of 3293 patients undergoing aortic valve replacement (AVR) in a single institution suffered from dialysis-dependent ESRD and underwent a follow-up investigation after 1.9 years (median). Twelve (28.9 %) of these patients received a biological, 32 (71.1 %) of these patients a mechanical aortic valve prosthesis. To evaluate a possible influence of the valve type (biological/mechanical) on survival, uni- and multivariate logistic regression was used.
  
  
  RESULTS
  ESRD patients after AVR had a relatively poor short-term (30-day mortality: 22.7 %) and long-term survival (median survival time: 24.7 months; 95 % CI: 0.2-47.7 months), irrespective of the type of heart valve prosthesis (hazard ratio for mortality depending on heart valve type in dialysis patients: 1.31,  P = 0.400). Dialysis-dependent patients were not reoperated due to valve-related reasons.
  
  
  CONCLUSIONS
  The long-term survival of dialysis-dependent patients after AVR is low (5-year survival: 29.5 %) irrespective of the type of heart valve prosthesis. Therefore, the use of biological AVR is not contraindicated in this group of patients.
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Giessen, Giessen, Germany. andreas.boening@chiru.med.uni-giessen.de
authors.forename: A
authors.initials: A
authors.lastname: Böning
authors.forename: R H
authors.initials: RH
authors.lastname: Boedeker
authors.forename: U P
authors.initials: UP
authors.lastname: Rosendahl
authors.forename: B
authors.initials: B
authors.lastname: Niemann
authors.forename: S
authors.initials: S
authors.lastname: Haberer
authors.forename: P
authors.initials: P
authors.lastname: Roth
authors.forename: J A C
authors.initials: JA
authors.lastname: Ennker
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006349:Heart Valve Diseases / Q000601:surgery; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011474:Prosthesis Design; D011475:Prosthesis Failure; D006435:Renal Dialysis; D015996:Survival Rate