What question did this study set out to answer?

To compare long-term survival and reintervention-free survival between bovine pericardial and porcine biological prostheses in patients undergoing aortic valve replacement.

September 4, 2014European Journal of Cardio-Thoracic SurgeryOpen Access

A comparison of outcomes between bovine pericardial and porcine valves in 38 040 patients in England and Wales over 10 years

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Why the study?

Do bovine pericardial valves improve survival or reintervention-free survival compared to porcine valves in patients undergoing first-time AVR?

Population

38,040 patients undergoing first-time elective and urgent aortic valve replacement with or without…

Comparison

Bovine pericardial valves (n=24,688, 64.9%) vs Porcine valves (n=13,352, 35.1%)

Design

Cohort

Follow-up

median 3.6 years (up to 10 years)

Authors

GHGraeme L. HickeyMedtronic (United States)SGStuart W GrantCardiac Surgery BBBen BridgewaterManchester Academic Health Science Centre

Discussion

Member takes

Implication

No survival difference observed between valve types in AVR; leaves open need for RCTs to confirm long-term equivalence.

Key Points

To compare long-term survival and reintervention-free survival between bovine pericardial and porcine biological prostheses in patients undergoing aortic valve replacement.
Retrospective observational analysis of prospectively gathered registry data (NICOR) covering N=38,040 patients undergoing first-time elective or urgent AVR with or without CABG in England and Wales from April 2003 to March 2013.
Outcomes were tracked via the Office for National Statistics over a median follow-up of 3.6 years (up to 10 years) and evaluated using log-rank tests and Cox proportional hazards models with surgeon-level frailty adjustments.
Ten-year overall survival was 49.0% for the bovine pericardial group (64.9% of cohort) and 50.3% for the porcine group (35.1% of cohort) (P = 0.767).
Porcine valves showed an adjusted hazard ratio of 0.98 (95% CI: 0.93–1.03) for reintervention-free survival compared with bovine pericardial valves, with no divergence in sensitivity analyses of small valve sizes.

Structured PICO

Do bovine pericardial valves improve survival or reintervention-free survival compared to porcine valves in patients undergoing first-time AVR?

Population

38,040 patients undergoing first-time elective and urgent aortic valve replacement (AVR) with or without concomitant coronary artery bypass graft (CABG) surgery in England and Wales between April 2003 and March 2013

Intervention

Bovine pericardial valves (n=24,688, 64.9%)

Comparator

Porcine valves (n=13,352, 35.1%)

Outcome

Survival and reintervention-free survivalhard clinical

Bovine pericardial and porcine biological valves offer comparable survival and reintervention-free survival up to 10 years in patients undergoing first-time AVR.

Cite This Study

Hickey et al. (2014) studied this question.

synapsesocial.com/papers/6a7f29f3363dc28cab6f346f https://doi.org/10.1093/ejcts/ezu307

Topics

Valvular heart disease Congenital heart disease adults

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A comparison of outcomes between bovine pericardial and porcine valves in 38 040 patients in England and Wales over 10 years

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

A comparison of outcomes between bovine pericardial and porcine valves in 38 040 patients in England and Wales over 10 years

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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