Why the study?
Limited data were available regarding comparative outcomes of redo aortic valve interventions after AVR with either stented or stentless bioprostheses.
Does the type of previous bioprosthesis (stentless vs stented) affect outcomes after redo aortic valve intervention in patients with infective endocarditis or structural valve deterioration?
Does the type of previous bioprosthesis (stentless vs stented) affect outcomes after redo aortic valve intervention in patients with infective endocarditis or structural valve deterioration?
Redo aortic valve interventions have comparable early and mid-term survival outcomes regardless of whether the initial bioprosthesis was stented or stentless.
No immediate change to AVR prosthesis selection; leaves open comparative redo outcomes after stented versus stentless bioprostheses.
BACKGROUND: Limited data are available concerning comparative outcomes of redo aortic valve interventions, including surgery after aortic valve replacement (AVR) with either stented or stentless bioprostheses. We investigated the comparative outcomes of redo aortic valve interventions, including surgery after AVR with either stented or stentless bioprostheses. METHODS: The cohort consisted of 112 patients who underwent aortic valve intervention for infective endocarditis or structural valve deterioration between 2001 and 2020. One hundred patients received a stented valve (stented group) and 12 patients received a stentless valve (stentless group) during the initial surgery. Early and late outcomes were evaluated. RESULTS: The mean [IQR] ages during the current interventions were 66 [54, 77] years in the stented group and 74 [67, 79] years in the stentless group (P = 0.13). In the stented group, aortic valve interventions included redo AVRs with stented valves (n = 54), mechanical valves (n = 26), stentless valves (n = 16), and transcatheter aortic valve implantations (n = 4). In the stentless group, redo AVRs were performed with stented valves (n = 4), mechanical valves (n = 2), stentless valves (n = 1), and transcatheter valve implantations (n = 5). Hospital mortality was observed in 2 (2%) patients in the stented group and 1 (8%) patients in the stentless group (P = 0.29). The 5-year survival was 80.8% [66.8, 88.5] in the stented group and 91.7% [53.9, 98.8] in stentless group. Statistically significant differences in thromboembolisms were observed between the groups. CONCLUSIONS: No significant differences in early and mid-term outcomes (except thromboembolism) after aortic valve interventions were detected between patients with stented and stentless AVRs.
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Fukunaga et al. (2023) studied this question.
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