Comparative Effectiveness of Mechanical Valves and Homografts in Complex Aortic Endocarditis
نویسندگان
چکیده
BackgroundThe ideal surgical reconstruction of the aortic root in patients with complex endocarditis is controversial. We compared short- and long-term outcomes between mechanical valves, bioprostheses, homografts.MethodsWe identified all undergoing an operation for active at our institution 2003 2017. grouped according to those who received a valve, bioprosthesis, or homograft. used multiple logistic regression proportional hazards models. To minimize confounding by indication, we marginal risk adjustment simulate that every patient would undergo (contrary fact) 3 operations.ResultsOf 159 endocarditis, 48 (30.2%) had valve plus patch reconstruction, 85 (53.4%) replacement. Of all, 50 (31.5%) 56 (35.2%) 53 (33.3%) The groups were similar age, sex, body mass index, comorbid conditions, organism, abscess location, mitral involvement (all P > .05). However, receiving reconstructions more likely have native (46% vs 37.5% 17%; = .005) less replacement (32% 28.6% 100%; < .001). Marginal risk-adjusted operative mortality was lowest valves (4.8%) highest homografts (16.9%; .041). Long-term survival after worse than conduits (adjusted hazard ratio, 2.9; .045).ConclusionsIn are associated similar, if not better, homografts, even adjusting important baseline characteristics limiting analysis replacements only. homografts. operations. .045). In
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ژورنال
عنوان ژورنال: The Annals of Thoracic Surgery
سال: 2021
ISSN: ['1552-6259', '0003-4975']
DOI: https://doi.org/10.1016/j.athoracsur.2020.06.082