Influence of Prosthesis Type on Long-Term Survival after Re-replacement of Aortic Valve Prosthesis


  • Payam Akhyari
  • Artur Lichtenberg
  • Alexander Hartmann
  • Issam Ismail
  • Kamiya Hiroyuki
  • Jan-Philipp Minol
  • Theodoros Kofidis
  • Uwe Klima
  • Matthias Karck
  • Axel Haverich



Background: The purpose of this study is to examine the influence of the prosthesis type on early mortality and long-term survival after re-replacement of aortic valve prosthesis, especially in patients over 60 years old.

Methods: Late outcome of 223 patients who underwent a reoperation on the aortic valve and received a mechanical (mechanical group) or biological (biological group) heart valve prosthesis at a single institution were analyzed for survival and major valve-related complications, including structural valve deterioration, thromboembolism, hemorrhage, further reoperation, and valve-related mortality.

Results: Preoperative New York Heart Association class IV (P = 0.001), emergency procedure (P = 0.002), and endocarditis (P = 0.025) were significant risk factors for 30-day mortality rates, which were 8.4 % and 12.5 %, respectively (mechanical versus biological group, P = 0.361). A subanalysis of elective patients revealed a low risk of 30-day mortality of 2.4 % and 1.8 %, respectively. Event-free survival was comparable at 5 years (73.9% ± 3.6% versus 70.5% ± 6.5%, mechanical versus biological group) and 10 year (49.7% ± 5.0% versus 35.3% ± 9.8%, mechanical versus biological group). In a propensity-matched subanalysis, survival and event-free survival were comparable at 5 and 10 years in both groups.

Conclusion: The type of aortic valve prosthesis did not affect early outcome and late survival in patients who underwent valve replacement, and therefore, the current strategy favoring a biological aortic valve prosthesis for patients aged over 60 years in first-time operations could also be applied in re-replacement.


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How to Cite

Akhyari, P., Lichtenberg, A., Hartmann, A., Ismail, I., Hiroyuki, K., Minol, J.-P., Kofidis, T., Klima, U., Karck, M., & Haverich, A. (2013). Influence of Prosthesis Type on Long-Term Survival after Re-replacement of Aortic Valve Prosthesis. The Heart Surgery Forum, 16(6), E298-E302.