青少年和成人肺动脉瓣置换术的长期结果：一项全国性的基于人群的研究

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-06-07 DOI:10.1016/j.ijcard.2025.133425

Jae Hong Lim , Sungkyu Cho , Jae Woong Choi , Mi-Sook Kim , Jinhee Kim

{"title":"青少年和成人肺动脉瓣置换术的长期结果：一项全国性的基于人群的研究","authors":"Jae Hong Lim , Sungkyu Cho , Jae Woong Choi , Mi-Sook Kim , Jinhee Kim","doi":"10.1016/j.ijcard.2025.133425","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>A study using the National Health Insurance Service database compared bioprosthetic and mechanical pulmonary valve replacement clinical results.</div></div><div><h3>Methods</h3><div>Total of 1586 patients underwent pulmonary valve replacement from 2003 to 2021 and 1295 patients were enrolled after excluding those with previous aortic valve replacement and aged less than 13 years at operation. Bioprostheses (group B) and mechanical prostheses (group M) were used in 1085 patients (83.8 %) and 210 patients (16.2 %), respectively. Propensity score matching was performed. Sub-group analysis was performed in group B based on the materials (bovine vs. porcine).</div></div><div><h3>Results</h3><div>The mean age in group B and group M was 28.4 ± 14.5 and 33.9 ± 14.6 years old. There were no differences in operative mortality (<em>p</em> = 0.485) or postoperative complications (<em>p</em> = 0.573) between the groups. After matching, the cumulative incidence of infective endocarditis was lower in group B (<em>p</em> = 0.047). In the sub-group analysis in group B, the porcine group tended to lower reoperation rate compared to the bovine group. (before matching, <em>p</em> = 0.026; after matching <em>p</em> = 0.083).</div></div><div><h3>Conclusions</h3><div>Bioprostheses are favorable compared to mechanical prostheses due to its low complications and the avoidance of anticoagulation. Further studies with longer follow-up duration might be needed to analyze long term outcomes between bovine and porcine valves.</div></div>","PeriodicalId":13710,"journal":{"name":"International journal of cardiology","volume":"437 ","pages":"Article 133425"},"PeriodicalIF":3.2000,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term outcomes of pulmonary valve replacement in adolescents and adults: A nationwide population-based study\",\"authors\":\"Jae Hong Lim , Sungkyu Cho , Jae Woong Choi , Mi-Sook Kim , Jinhee Kim\",\"doi\":\"10.1016/j.ijcard.2025.133425\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>A study using the National Health Insurance Service database compared bioprosthetic and mechanical pulmonary valve replacement clinical results.</div></div><div><h3>Methods</h3><div>Total of 1586 patients underwent pulmonary valve replacement from 2003 to 2021 and 1295 patients were enrolled after excluding those with previous aortic valve replacement and aged less than 13 years at operation. Bioprostheses (group B) and mechanical prostheses (group M) were used in 1085 patients (83.8 %) and 210 patients (16.2 %), respectively. Propensity score matching was performed. Sub-group analysis was performed in group B based on the materials (bovine vs. porcine).</div></div><div><h3>Results</h3><div>The mean age in group B and group M was 28.4 ± 14.5 and 33.9 ± 14.6 years old. There were no differences in operative mortality (<em>p</em> = 0.485) or postoperative complications (<em>p</em> = 0.573) between the groups. After matching, the cumulative incidence of infective endocarditis was lower in group B (<em>p</em> = 0.047). In the sub-group analysis in group B, the porcine group tended to lower reoperation rate compared to the bovine group. (before matching, <em>p</em> = 0.026; after matching <em>p</em> = 0.083).</div></div><div><h3>Conclusions</h3><div>Bioprostheses are favorable compared to mechanical prostheses due to its low complications and the avoidance of anticoagulation. Further studies with longer follow-up duration might be needed to analyze long term outcomes between bovine and porcine valves.</div></div>\",\"PeriodicalId\":13710,\"journal\":{\"name\":\"International journal of cardiology\",\"volume\":\"437 \",\"pages\":\"Article 133425\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-06-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International journal of cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167527325004681\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167527325004681","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

目的利用国民健康保险服务数据库比较生物假体与机械肺瓣膜置换术的临床效果。方法2003年至2021年共纳入1586例肺动脉瓣置换术患者，剔除既往主动脉瓣置换术且手术年龄小于13岁的1295例患者。生物假体（B组）1085例（83.8%），机械假体（M组）210例（16.2%）。进行倾向评分匹配。B组根据材料（牛与猪）进行亚组分析。结果B组和M组患者平均年龄分别为28.4±14.5岁和33.9±14.6岁。两组手术死亡率（p = 0.485）和术后并发症（p = 0.573）差异无统计学意义。配对后，B组感染性心内膜炎的累计发生率较低（p = 0.047）。在B组的亚组分析中，猪组的再手术率比牛组低。(配对前，p = 0.026；p = 0.083)。结论与机械假体相比，生物假体具有并发症少、避免抗凝等优点。可能需要进行更长的随访时间的进一步研究来分析牛和猪瓣膜之间的长期结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Long-term outcomes of pulmonary valve replacement in adolescents and adults: A nationwide population-based study

Objective

A study using the National Health Insurance Service database compared bioprosthetic and mechanical pulmonary valve replacement clinical results.

Methods

Total of 1586 patients underwent pulmonary valve replacement from 2003 to 2021 and 1295 patients were enrolled after excluding those with previous aortic valve replacement and aged less than 13 years at operation. Bioprostheses (group B) and mechanical prostheses (group M) were used in 1085 patients (83.8 %) and 210 patients (16.2 %), respectively. Propensity score matching was performed. Sub-group analysis was performed in group B based on the materials (bovine vs. porcine).

Results

The mean age in group B and group M was 28.4 ± 14.5 and 33.9 ± 14.6 years old. There were no differences in operative mortality (p = 0.485) or postoperative complications (p = 0.573) between the groups. After matching, the cumulative incidence of infective endocarditis was lower in group B (p = 0.047). In the sub-group analysis in group B, the porcine group tended to lower reoperation rate compared to the bovine group. (before matching, p = 0.026; after matching p = 0.083).

Conclusions

Bioprostheses are favorable compared to mechanical prostheses due to its low complications and the avoidance of anticoagulation. Further studies with longer follow-up duration might be needed to analyze long term outcomes between bovine and porcine valves.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.