This study was designed to determine the effects of age, coronary artery disease and other cardiac comorbidities on late outcome following bioprosthetic aortic valve replacement.
Data were prospectively collected on 670 patients undergoing aortic valve replacement with the Hancock II bioprosthesis (Medtronic, Inc, Minneapolis, Minn) between 1982 and 1994. Mean patient age was 65 +/- 12 years (median, 68 years; range, 18-86 years). Follow-up was 99.7% complete at 69 +/- 40 months (median, 66 months; range, 0. 1-168 months). Survival and freedom from reoperation were evaluated univariately by Kaplan-Meier analysis and multivariably by Cox regression.
After adjustment for gender, Cox regression analysis revealed that age of 65 years or older, left ventricular dysfunction, the presence of coronary artery disease, and advanced New York Heart Association functional classification were associated with a higher risk of late death. At 12 years, survival was significantly different by Kaplan-Meier analysis for both age younger than 65 years (71% +/- 4%) versus age 65 years or older (36% +/- 7%; P