Comparative Assessment of the Results of Application of Modern Russian Models of Mechanical and Biological Prosthetic Heart Valves in Isolated Aortic Valvular Disease

Natalia V. Rogulina ¹, Yuriy N. Odarenko ¹, Stanislav G. Kokorin ¹, Leonid S. Barbarash ²

¹ Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases” , Kemerovo, Russia; ² Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”, Kemerovo, Russia;

Date, time and location: 2018.05.25 15:30, Exhibition area, 1st Floor. Zone – D

Abstract

Purpose:We aimed to evaluate the immediate and long-term (up to 5 years) results of surgical treatment of isolated aortic valvular disease (iAVD) with the use of modern Russian models of mechanical and biological prostheses.

Material and methods:From 2011 to 2017 227 patients were operated for iAVD. We implanted 90 “MedEng-2” prostheses and 137 “UniLine” heart valve bioprostheses. The mean age of “MedEng-2” recipients was 14 years younger than in “UniLine” group and was 52.9±5.6 years (р=0.001).

Results:The in-hospital mortality was significantly higher in the group of bioprostheses and was 4.4% (n=6) vs 1.1% (n=1) in “MedEng-2” recipients (р=0.001).The linearized indices of the long-term mortality in“UniLine” and “MedEng-2” groups were 1.29% and 0.94%/patient-years(р≥0.050).The actuarial indices of the overall survival by the 5^th year of follow-up in the groups of mechanical and biological prostheses were92.5 and 89.4%,respectively(р≥0.050).Thromboembolism and clinically significant bleedings were significantly more frequent in“MedEng-2” recipients (р≤0.001).The linearized indices of thromboembolism in the groups of“MedEng-2” and “UniLine” were 3.79 and 0.52%/patient-years(р=0.001). The bleeding rate was 1.89 and 0.26%/patient-years, respectively(р=0.001).

During the 5-yearfollow-up period there were no any dysfunctions of “UniLine” prostheses. In the group of “MedEng-2” recipients 2 patients were successfully re-operated for thrombosis of the prosthesis.The linearized index of reoperations in“MedEng-2” recipients was 0.6% /patient-years.

Conclusion:The application of “UniLine” bioprosthesis in aortic valvular disease in elderly patients demonstrates high survival rates. The absence of necessity in anticoagulant therapy in bioprosthetics practically eliminates the risk of such complications as bleedings and thromboembolism. The recipients of mechanical valves need a careful monitoring of anticoagulant therapy. “UniLine” bioprosthesis in the aortic position demonstrated high resistance to the primary tissue failure and infective endocarditis during the first 5 years after implantation.