Long-term results of mechanical and biological heart valves in dialysis and non-dialysis patients

• Published in: The Thoracic and cardiovascular surgeon Vol. 59; no. 8; p. 454
• Main Authors: Böning, A, Boedeker, R H, Rosendahl, U P, Niemann, B, Haberer, S, Roth, P, Ennker, J A C
• Format: Journal Article
• Language: English
• Published: Germany 01.12.2011
• Subjects: Aged; Analysis of Variance; Aortic Valve - surgery; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - surgery; Bioprosthesis; Female; Follow-Up Studies; Germany - epidemiology; Heart Valve Diseases - surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Kidney Failure, Chronic - mortality; Kidney Failure, Chronic - therapy; Male; Middle Aged; Multivariate Analysis; Prognosis; Prosthesis Design; Prosthesis Failure; Renal Dialysis; Survival Rate; Germany
• ISSN: 1439-1902
• DOI: 10.1055/s-0030-1271028

We wanted to answer the question whether biological heart valves are inferior compared to mechanical heart valves in end-stage renal disease (ESRD) patients. Between 01/1996 und 12/2006, 44 of 3293 patients undergoing aortic valve replacement (AVR) in a single institution suffered from dialysis-dependent ESRD and underwent a follow-up investigation after 1.9 years (median). Twelve (28.9 %) of these patients received a biological, 32 (71.1 %) of these patients a mechanical aortic valve prosthesis. To evaluate a possible influence of the valve type (biological/mechanical) on survival, uni- and multivariate logistic regression was used. ESRD patients after AVR had a relatively poor short-term (30-day mortality: 22.7 %) and long-term survival (median survival time: 24.7 months; 95 % CI: 0.2-47.7 months), irrespective of the type of heart valve prosthesis (hazard ratio for mortality depending on heart valve type in dialysis patients: 1.31, P = 0.400). Dialysis-dependent patients were not reoperated due to valve-related reasons. The long-term survival of dialysis-dependent patients after AVR is low (5-year survival: 29.5 %) irrespective of the type of heart valve prosthesis. Therefore, the use of biological AVR is not contraindicated in this group of patients.