The purpose of this study was to determine the prevalence and severity of para valvular regurgitation(PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. The initial AVERT cohort consisted of 807...The purpose of this study was to determine the prevalence and severity of para valvular regurgitation(PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. The initial AVERT cohort consisted of 807 patients randomized to receive either a Silzone coated prosthetic valve or a conventional prosthetic valve; early clinical reports showed higher rates of valve explant caused by PVR for Silzone coated prosthetic valve. Of the 678 eligible patients, 575(85%) underwent postoperative transthoracic echocardiograms. The presence and severity of PVR were identified by color flow Doppler. Reviewers were blinded to the typ e of prosthetic valve and the demographic and clinical variables. Among those wh o underwent echocardiography (Silzone coated prosthetic valve, n=285 and conven tional prosthetic valve, n=290), 59%had prosthetic aortic valves, 32%prostheti c mitral valves, and 9%had both; demographic and clinical findings (i.e., prost hetic valve endocarditis, thromboembolism, bleeding, and all cause death) were similar for the two groups. Echocardiographically determined PVR was present in 50 valves: Silzone coated prosthetic valve, 29 of 285 (10%) and conventional p rosthetic valve, 21 of 290(7%, p=NS); the severity of PVR was similar in both g roups. Kaplan Meier analysis showed no significant differences in PVR at 24 mon ths from valve implantation between the two groups(24-month event free rate: 9 3%Silzone coated prosthetic valve vs. 94%conventional prosthetic valve, p=NS) . Excluding those patients who had initial prosthetic valve explant, the two ye ar echocardiographic follow up of the AVERT cohort shows no statistically signi ficant differences in the prevalence or severity of PVR in the Silzone coated p rosthetic valve compared with the conventional prosthetic valve. Further monitor ing is warranted to determine whether these clinical outcomes remain similar on long term follow up.展开更多
文摘The purpose of this study was to determine the prevalence and severity of para valvular regurgitation(PVR) in the Artificial Valve Endocarditis Reduction Trial (AVERT) cohort. The initial AVERT cohort consisted of 807 patients randomized to receive either a Silzone coated prosthetic valve or a conventional prosthetic valve; early clinical reports showed higher rates of valve explant caused by PVR for Silzone coated prosthetic valve. Of the 678 eligible patients, 575(85%) underwent postoperative transthoracic echocardiograms. The presence and severity of PVR were identified by color flow Doppler. Reviewers were blinded to the typ e of prosthetic valve and the demographic and clinical variables. Among those wh o underwent echocardiography (Silzone coated prosthetic valve, n=285 and conven tional prosthetic valve, n=290), 59%had prosthetic aortic valves, 32%prostheti c mitral valves, and 9%had both; demographic and clinical findings (i.e., prost hetic valve endocarditis, thromboembolism, bleeding, and all cause death) were similar for the two groups. Echocardiographically determined PVR was present in 50 valves: Silzone coated prosthetic valve, 29 of 285 (10%) and conventional p rosthetic valve, 21 of 290(7%, p=NS); the severity of PVR was similar in both g roups. Kaplan Meier analysis showed no significant differences in PVR at 24 mon ths from valve implantation between the two groups(24-month event free rate: 9 3%Silzone coated prosthetic valve vs. 94%conventional prosthetic valve, p=NS) . Excluding those patients who had initial prosthetic valve explant, the two ye ar echocardiographic follow up of the AVERT cohort shows no statistically signi ficant differences in the prevalence or severity of PVR in the Silzone coated p rosthetic valve compared with the conventional prosthetic valve. Further monitor ing is warranted to determine whether these clinical outcomes remain similar on long term follow up.
