What is the clinical evidence from this study?

Study design: Cohort. Population: Mitral valve disease requiring replacement (n=135). Intervention: Bioprosthetic mitral valve replacement. Primary outcome: Structural valve failure.

What question did this study set out to answer?

To assess the long-term clinical durability, failure rates, and patient outcomes following isolated bioprosthetic mitral valve replacement in young patients.

November 1, 1984European Heart Journal

Bioprosthetic valve replacement in children—long-term follow-up of 135 isolated mitral valve implantations*

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Key result

Bioprosthetic mitral valve replacement in children demonstrates a prohibitive ~23% annual structural valve failure rate.

n=135

Population

135 patients, age 20 years or younger, undergoing isolated mitral valve replacement. All patients were in…

Design

Cohort

Follow-up

Cumulative 356 patient-years (up to 7 years actuarial)

Authors

MAManuel J. AntunesCardiac Surgery

Discussion

Member takes

Implication

High failure rates support caution with bioprosthetic mitral valves in children; leaves open durability of contemporary prostheses.

Key Points

To assess the long-term clinical durability, failure rates, and patient outcomes following isolated bioprosthetic mitral valve replacement in young patients.
Followed a cohort of 135 patients aged 20 years or younger (mean age 13.7 ± 3.46 years; NYHA class III/IV) who received isolated mitral valve replacements between August 1976 and January 1980.
Implanted bioprostheses included 37 Hancock, 4 Angell-Shiley, and 94 Carpentier-Edwards valves, followed for a cumulative period of 356 patient-years.
Early mortality was 4.4% (6 patients), and late mortality was 10.7% per patient-year (38 patients), with 26 deaths (7.3% per patient-year) attributed to valve-related complications.
Structural valve failure occurred in 80 instances (22.5% per patient-year), prompting reoperation in 64 patients (18% per patient-year).
Seven-year actuarial overall survival was 50%, complication-free valve survival was 15%, and only 7 patients (5.2%) retained their original non-degenerated bioprostheses.

Study Design

Type

Cohort (n=135)

Structured PICO

Population

135 patients aged 20 years or younger who underwent isolated mitral valve replacement with a bioprosthesis, followed for a cumulative 356 patient-years.

Exposure

Bioprosthetic mitral valve replacement (37 Hancock, 4 Angell-Shiley, and 94 Carpentier-Edwards prostheses)

Outcome

Structural valve failure and actuarial survival at 7 yearshard clinical

Bioprosthetic mitral valves have a prohibitive failure rate in children, with only 15% complication-free valve survival at 7 years, indicating they should be avoided or replaced early when degenerating.

Cite This Study

Manuel J. Antunes (1984) conducted a cohort in Mitral valve disease requiring replacement (n=135). Bioprosthetic mitral valve replacement was evaluated on Structural valve failure. Bioprosthetic mitral valve replacement in children demonstrated a prohibitive failure rate, with structural valve failure occurring at 22.5% per patient-year and 7-year actuarial survival of 50%.

synapsesocial.com/papers/6aa0ce77b6ff41cbc45b842f https://doi.org/10.1093/oxfordjournals.eurheartj.a061591

Topics

Valvular heart disease

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Bioprosthetic valve replacement in children—long-term follow-up of 135 isolated mitral valve implantations*

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Bioprosthetic valve replacement in children—long-term follow-up of 135 isolated mitral valve implantations*

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider