Department of Cardiovascular Surgery & Transplantology, Jagiellonian University Medical College, Institute of Cardiology, John Paul II Hospital, Krakow, Poland.
Department of Cardiovascular Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
J Comp Eff Res. 2023 Mar;12(3):e220180. doi: 10.2217/cer-2022-0180. Epub 2023 Jan 23.
Durability of aortic valve replacement is becoming increasingly important. Aortic bioprostheses with RESILIA tissue have demonstrated outstanding outcomes thus far, but only in single-arm studies. We compared structural valve deterioration (SVD)-related hemodynamic valve deterioration (HVD) of grade ≥2 of RESILIA tissue valves from the COMMENCE trial (n = 689) to those from the PARTNER 2A contemporary AVR arm (n = 936) based upon annual core laboratory echocardiograms through 5 years of follow-up. SVD-related HVD in the COMMENCE and PARTNER 2A cohorts were 1.8 versus 3.5%, respectively (one-sided 95% lower-bound hazard ratio of 0.92; p = 0.07). In propensity-matched cohorts (n = 239), these outcomes were 1.0 versus 4.8%, respectively (one-sided 95% lower-bound hazard ratio of 1.15; p = 0.03). RESILIA tissue-based AVR exhibited reduced SVD-related HVD compared with a contemporary AVR cohort devoid of RESILIA tissue.
主动脉瓣置换的耐久性变得越来越重要。迄今为止，具有 RESILIA 组织的生物瓣在单臂研究中表现出了出色的结果，但仅限于单臂研究。我们通过 5 年的随访，比较了来自 COMMENCE 试验（n=689）和 PARTNER 2A 当代 AVR 臂（n=936）的 RESILIA 组织瓣膜的结构性瓣膜退化（SVD）相关的血流动力学瓣膜退化（HVD）。COMMENCE 和 PARTNER 2A 队列中的 SVD 相关 HVD 分别为 1.8%和 3.5%（单侧 95%下限危险比为 0.92；p=0.07）。在倾向评分匹配队列（n=239）中，这些结果分别为 1.0%和 4.8%（单侧 95%下限危险比为 1.15；p=0.03）。与缺乏 RESILIA 组织的当代 AVR 队列相比，基于 RESILIA 组织的 AVR 显示出降低的 SVD 相关 HVD。
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