Key result
Mechanical AVR linked to ~45% lower long-term mortality versus bioprostheses in endocarditis patients aged 40-65.
Why the study?
Whether the type of prosthesis implanted for aortic valve replacement for infective endocarditis impacts patient survival is a matter of debate.
Does mechanical aortic valve prosthesis improve long-term survival and reduce recurrence of endocarditis compared to biological prosthesis in patients aged 40 to 65 years undergoing AVR for infective endocarditis?
Cohort (n=549)
Does mechanical aortic valve prosthesis improve long-term survival and reduce recurrence of endocarditis compared to biological prosthesis in patients aged 40 to 65 years undergoing AVR for infective endocarditis?
In middle-aged patients (40-65 years) undergoing aortic valve replacement for infective endocarditis, mechanical prostheses were associated with improved long-term survival and reduced recurrence of endocarditis compared to biological prostheses.
Answers are grounded in this paper and cite their sources.
Mechanical prostheses were associated with better survival and fewer recurrences in IE; leaves open whether RCTs would confirm benefit for ages 40-65.
Background: Infective endocarditis(IE) is a serious disease and in many cases surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement(AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival, recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years. Methods: This was an analysis of the INFECT-REGISTRY. Overall, 4365 patients were diagnosed and operated on for IE from 2000 to 2021. Of these, 549 aged between 40 and 65 years underwent AVR. 268(48.8%) received mechanical prostheses, and 281(51.2%) biological ones. Confounders were adjusted using optimal full matching propensity score. Results: A significant trend in reduction of implantation of mechanical vs biological prostheses was observed during the study period(p<0.0001). Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546,95%CI: 0.322-0.926, p=0.025). Mechanical prostheses were significantly associated with less recurrent endocarditis after AVR (HR 0.268,95%CI:0.077-0.933,p=0.039).Conclusions: The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after mechanical aortic valve prosthesis implant for IE in middle-aged patients.
No takes yet. Share an insight, caveat, or question.
Salsano et al. (2023) conducted a cohort in Infective endocarditis (n=549). Mechanical aortic valve prosthesis vs. Biological aortic valve prosthesis was evaluated on Long-term survival (HR 0.546, 95% CI 0.322-0.926, p=0.025). Mechanical aortic valve replacement for infective endocarditis in patients aged 40-65 years improved long-term survival compared to biological prostheses (HR 0.546; 95% CI 0.322-0.926; p=0.025).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: