Abstract
Introduction: There are no guidelines regarding the use
of bovine pericardial or porcine valves for aortic valve replacement,
and prior studies have yielded conflicting results. The current study
sought to compare short- and long-term outcomes in propensity-matched
cohorts of patients undergoing isolated AVR with bovine versus porcine
valves. Methods: This was a retrospective study
utilizing an institutional database of all isolated bioprosthetic
surgical aortic valve replacements performed at our center from 2010 to
2020. Patients were stratified according to type of bioprosthetic valve
(bovine pericardial or porcine), and 1:1 propensity-score matching was
applied. Kaplan-Meier survival estimation and multivariable Cox
regression for mortality were performed. Cumulative incidence functions
were generated for all-cause readmissions and aortic valve
reinterventions. Results: A total of 1,502 patients were
identified, 1,090 (72.6%) of whom received a bovine prosthesis and 412
(27.4%) of whom received a porcine prosthesis. Propensity-score
matching resulted in 412 risk-adjusted pairs. There were no significant
differences in clinical or echocardiographic postoperative outcomes in
the matched cohorts. Kaplan-Meier survival estimates were comparable,
and, on multivariable Cox regression, valve type was not significantly
associated with long-term mortality (HR 1.02, 95% CI: 0.74, 1.40,
p=0.924). Additionally, there were no significant differences in
competing-risk cumulative incidence estimates for all-cause readmissions
(p=0.68) or aortic valve reinterventions (p=0.25) in the matched
cohorts. Conclusion: The use of either bovine or porcine
bioprosthetic aortic valves yields comparable postoperative outcomes,
long-term survival, freedom from reintervention, and freedom from
readmission.