title: Comparable long-term results for porcine and pericardial prostheses after isolated aortic valve replacement.
abstract: OBJECTIVE
  Outcome of aortic valve replacement may be influenced by the choice of bioprosthesis. Pericardial heart valves are described to have a favourable haemodynamic profile compared with porcine valves, although the clinical notability of this finding is still controversially debated. Herein, we compared the long-term results of two commonly implanted bioprosthesis at a single centre.
  
  
  METHODS
  All consecutive patients undergoing isolated aortic valve replacement with either a Carpentier-Edwards Magna pericardial prosthesis or a Medtronic Mosaic porcine prosthesis between 2002 and 2008 were analysed regarding preoperative characteristics, short- and long-term survival, valve-related complications and echocardiographic findings.
  
  
  RESULTS
  The Medtronic Mosaic was implanted in 163 patients and the Carpentier-Edwards Magna in 295 patients. The sizes of implanted valves were 22.4 ± 1.5 mm for the Mosaic and 21.8 ± 1.8 mm for the Magna (P = 0.001). The long-term survival rate was 76 and 56% after 5 and 10 years for the Medtronic Mosaic, which was comparable with the Carpentier-Edwards Magna (77 and 57%; P = 0.92). Overall long-term survival was comparable with an age- and sex-matched Austrian general population for both groups. Valve-related adverse events were similar between groups. The postoperative mean transvalvular gradient was significantly increased in the Mosaic group (24 ± 9 mmHg vs 17 ± 7 mmHg; P < 0.001).
  
  
  CONCLUSIONS
  Both types of aortic bioprostheses offer excellent results after isolated aortic valve replacement. Despite relevant differences in gradients, long-term survival was comparable with the expected normal survival for both bioprostheses. Patients with a porcine heart valve had a higher postoperative transvalvular gradient.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria martin.andreas@meduniwien.ac.at.
authors.forename: Martin
authors.initials: M
authors.lastname: Andreas
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wallner
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical University of Vienna, Vienna, Austria Department of Anesthesiology, University Hospital Zuerich, Zuerich, Switzerland.
authors.forename: Kurt
authors.initials: K
authors.lastname: Ruetzler
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Dominik
authors.initials: D
authors.lastname: Wiedemann
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Marek
authors.initials: M
authors.lastname: Ehrlich
authors.affiliation: Center for Medical Statistics, Informatics and Intelligent Systems, Section for Medical Information Management and Imaging, Medical University of Vienna, Vienna, Austria.
authors.forename: Georg
authors.initials: G
authors.lastname: Heinze
authors.affiliation: Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Binder
authors.affiliation: Department of Thoracic, Cardiac and Thoracovascular Surgery, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
authors.forename: Anton
authors.initials: A
authors.lastname: Moritz
authors.affiliation: Department of Anesthesiology and Intensive Care, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Hiesmayr
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Alfred
authors.initials: A
authors.lastname: Kocher
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Guenther
authors.initials: G
authors.lastname: Laufer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D001705:Bioprosthesis; D002423:Cause of Death; D015331:Cohort Studies; D015150:Echocardiography, Doppler; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods* / Q000401:mortality*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D010496:Pericardium / Q000601:surgery / Q000637:transplantation; D011379:Prognosis; D016016:Proportional Hazards Models; D011474:Prosthesis Design / Q000379:methods*; D011475:Prosthesis Failure; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Aortic valve replacement; Biological heart valves; Bioprosthesis; Survival analysis