{"title":"新型机械瓣膜与支架生物瓣膜在65岁以上患者分离二尖瓣置换术中的比较","authors":"Antonio Piperata MD, PhD , Carlo Mariani MD, PhD , Giacomo Murana MD, PhD , Elio Fabbri PhD , Paola Rucci PhD , Maria Francesca Scuppa MD , Filippo Londi MD , Edoardo Bianco MD , Benedetta Guerrini MD , Ivan Tammaro MD , Ludovica Fabiani MD , Margherita Careddu MD , Marta Bellomare MD , Silvia Snaidero MD , Riccardo Nania MD , Sabrina Castagnini MD , Marta Di Carlo MD , Valentina Orioli MD , Gianluca Folesani MD , Davide Pacini MD, PhD","doi":"10.1016/j.xjon.2025.06.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To compare early and long-term clinical outcomes of bioprosthetic versus mechanical (On-X) mitral valve replacement (MVR) in patients aged 65 years and older.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included consecutive patients equal to or older than 65 years underwent isolated MVR from 2005 to 2023. A propensity score-matched analysis was performed to compare early- and long-term clinical outcomes between patients with bioprostheses and mechanical On-X valve.</div></div><div><h3>Results</h3><div>A total of 330 patients were included, of whom 232 (70.3%) experienced bioprosthetic mitral valve replacement (BMVR group) and 98 (29.7%) mechanical mitral valve replacement (MMVR group) with On-X prosthesis. Propensity score analysis allowed to match 98 patients from each group. In the matched cohorts, the overall survival at 1, 5, and 10 years was 97.7%, 86.5%, and 69.5% for the MMVR group and 89.6%, 80.8%, and 62.5% for the BMVR (log-rank test: 1.88, <em>P</em> = .170). The 1-, 5-, and 10-year freedom from reoperation, endocarditis, pacemaker implantation, and hemorrhagic events were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>In patients older than 65 years requiring isolated MVR, the use of On-X mechanical prosthesis showed comparable long-term outcomes over bioprostheses.</div></div>","PeriodicalId":74032,"journal":{"name":"JTCVS open","volume":"26 ","pages":"Pages 85-93"},"PeriodicalIF":1.9000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of a novel mechanical valve versus stented bioprosthetic valves for isolated mitral valve replacement in patients older than 65 years\",\"authors\":\"Antonio Piperata MD, PhD , Carlo Mariani MD, PhD , Giacomo Murana MD, PhD , Elio Fabbri PhD , Paola Rucci PhD , Maria Francesca Scuppa MD , Filippo Londi MD , Edoardo Bianco MD , Benedetta Guerrini MD , Ivan Tammaro MD , Ludovica Fabiani MD , Margherita Careddu MD , Marta Bellomare MD , Silvia Snaidero MD , Riccardo Nania MD , Sabrina Castagnini MD , Marta Di Carlo MD , Valentina Orioli MD , Gianluca Folesani MD , Davide Pacini MD, PhD\",\"doi\":\"10.1016/j.xjon.2025.06.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To compare early and long-term clinical outcomes of bioprosthetic versus mechanical (On-X) mitral valve replacement (MVR) in patients aged 65 years and older.</div></div><div><h3>Methods</h3><div>This single-center retrospective study included consecutive patients equal to or older than 65 years underwent isolated MVR from 2005 to 2023. A propensity score-matched analysis was performed to compare early- and long-term clinical outcomes between patients with bioprostheses and mechanical On-X valve.</div></div><div><h3>Results</h3><div>A total of 330 patients were included, of whom 232 (70.3%) experienced bioprosthetic mitral valve replacement (BMVR group) and 98 (29.7%) mechanical mitral valve replacement (MMVR group) with On-X prosthesis. Propensity score analysis allowed to match 98 patients from each group. In the matched cohorts, the overall survival at 1, 5, and 10 years was 97.7%, 86.5%, and 69.5% for the MMVR group and 89.6%, 80.8%, and 62.5% for the BMVR (log-rank test: 1.88, <em>P</em> = .170). The 1-, 5-, and 10-year freedom from reoperation, endocarditis, pacemaker implantation, and hemorrhagic events were comparable between the 2 groups.</div></div><div><h3>Conclusions</h3><div>In patients older than 65 years requiring isolated MVR, the use of On-X mechanical prosthesis showed comparable long-term outcomes over bioprostheses.</div></div>\",\"PeriodicalId\":74032,\"journal\":{\"name\":\"JTCVS open\",\"volume\":\"26 \",\"pages\":\"Pages 85-93\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JTCVS open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666273625002219\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JTCVS open","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666273625002219","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Comparison of a novel mechanical valve versus stented bioprosthetic valves for isolated mitral valve replacement in patients older than 65 years
Objective
To compare early and long-term clinical outcomes of bioprosthetic versus mechanical (On-X) mitral valve replacement (MVR) in patients aged 65 years and older.
Methods
This single-center retrospective study included consecutive patients equal to or older than 65 years underwent isolated MVR from 2005 to 2023. A propensity score-matched analysis was performed to compare early- and long-term clinical outcomes between patients with bioprostheses and mechanical On-X valve.
Results
A total of 330 patients were included, of whom 232 (70.3%) experienced bioprosthetic mitral valve replacement (BMVR group) and 98 (29.7%) mechanical mitral valve replacement (MMVR group) with On-X prosthesis. Propensity score analysis allowed to match 98 patients from each group. In the matched cohorts, the overall survival at 1, 5, and 10 years was 97.7%, 86.5%, and 69.5% for the MMVR group and 89.6%, 80.8%, and 62.5% for the BMVR (log-rank test: 1.88, P = .170). The 1-, 5-, and 10-year freedom from reoperation, endocarditis, pacemaker implantation, and hemorrhagic events were comparable between the 2 groups.
Conclusions
In patients older than 65 years requiring isolated MVR, the use of On-X mechanical prosthesis showed comparable long-term outcomes over bioprostheses.
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