Late results of double-valve replacement with biologic or mechanical prostheses

Background. We previously showed that the risk of reoperation for structura l degeneration of bioprostheses was higher in cases involving patients olde r than 65 years (p = 0.003) and double-valve replacement (p = 0.02). The pu rpose of this study was to compare late outcome of mitral-aortic Valve repl acement using bioprostheses or mechanical valves. Methods. The bioprosthesis group included all mainland France residents (n = 48) between 55 and 65 years old operated on between 1980 and 1995 for mit ral-aortic valve replacement using bioprostheses. The mechanical valve grou p was obtained by matching each of these patients with a patient operated o n using mechanical valves at approximately the same time during the study. Results. In the bioprosthesis group, 10-year survival was 45% +/- 8% versus 62% +/- 7% in the mechanical valve group (not significant). The linearized reoperation rate was 6.8 per patient-year versus 1.1 per patient-year (p = 0.001), and the linearized reoperative mortality rate was 1.8 per patient- year and 0.7 per patient-year (not significant), respectively. Conclusions. The reoperative mortality risk after mitral-aortic valve repla cement using two bioprostheses does not significantly decrease overall surv ival after age 65 years. (C) 2001 by The Society of Thoracic Surgeons.