Life after heart surgery: Tracking the long-term performance of several bioprosthetic aortic valves

The Perimount aortic valve is associated with better long-term outcomes than other commonly used bioprosthetic aortic valves, according to new findings in JAMA Network Open.[1]

“Since bioprosthetic aortic valve replacement was first described in the 1960s, a wide range of different bioprosthetic models have been developed to improve patient outcomes,” wrote first author Michael Persson, MD, of the department of molecular medicine and surgery at Karolinska Institutet in Sweden, and colleagues. “Different xenograft materials have been used, such as porcine or bovine pericardium or valve tissue. Efforts to optimize the hemodynamic performance of bioprosthetic valves have included the supra-annular approach, external wrapping of leaflets around stents, and stentless designs. In attempts to improve the longevity of valves, different methods of tissue preservation and anticalcification treatments were developed.”

Persson et al. examined data from the SWEDEHEART registry to compare the long-term performance of some of Sweden’s most common bioprosthetic aortic valves. The team’s analysis included nearly 17,000 patients who underwent surgical aortic valve replacement (SAVR) with a bioprosthetic valve from 2003 to 2018. Patients who had undergone a previous cardiac surgery were excluded. The mean patient age was 72.6 years old, and 62.9% of patients were men. The mean follow-up period was 7.1 years.

The study’s primary outcome was the cumulative incidence of reintervention, which included an additional SAVR procedure or valve-in-valve transcatheter aortic valve replacement (TAVR). All-cause mortality and hospitalizations for heart failure were secondary outcomes the authors also evaluated.