Propensity score matching analysis of the aortiv valve replacement with the xenopericardial semi-framed prosthesis “T-Ara” and the framed xenopericardial prosthesis “UniLine”. Short-term results

Abstract

Highlights. It is the first pseudorandomized comparative study of xenopericardial frame and half-frame bioprostheses treated with diepoxin in the aortic position use and its direct results.Aim. A comparative assessment using the Propensity Score Matching method of the in-hospital clinical and hemodynamic results of the semi-framed epoxy-treated xenopericardial prosthesis “T-ara” and the framed epoxy-treated xenopericardial prosthesis “UniLine” (“NeoKor”, Kemerovo, Russia) for isolated aortic valve replacement implantation.Methods. 33 recipients of the “UniLine” prosthesis were selected by Propensity Score Matching method in a ratio of 1:1 to 33 observations from the “T-ara” group according to the compliance criteria: gender, age, body surface area, end-diastolic volume of the left ventricle (LV) and the pre-operative presence/absence of the aortic regurgitation.Results. Hospital mortality in the “T-ara” and “UniLine” groups was 3.03 (n = 1) and 6.06% (n = 2), respectively, p = 0.920. Non-fatal complications in the “T-ara” and “UniLine” groups was 7 (21.2%) and 18 (54.6%), p = 0.163. The incidence of postoperative heart failure and arrhythmias was higher in “UniLine” recipients (p = 0.001). The average stay in the intensive care unit was longer in the “UniLine” group than in the “T-ara” group, p = 0.05. Postoperative end-systolic and end-diastolic dimensions and volumes (and the corresponding indexes) of the LV,       as well as the myocardial mass and its index in both groups had no statistically significant changes in relation to preoperative data. The comparative assessment of left ventricular remodeling parameters depending on the prosthetic size revealed no significant differences. The average pressure gradient in the “T-ara» and “UniLine” group of size 21mm was 12.2±7.4 and 12.2±5.0 mm Hg. (p>0.050). The average pressure gradient in the group “T-ara” and “UniLine” size 23–25 mm was 10.2±4.1 and 9.9±0.3 mm Hg, p>0.050. The regression degree of LV myocardial mass index in the groups did not have significant differences.Conclusion. At the hospital stage, the semi-framed epoxy-treated biological prosthesis “T-ara” has a similar clinical and hemodynamic profile with the framed biological prosthesis “UniLine”. The frequency of postoperative heart  failure  and cardiac arrhythmias is statistically significantly higher in the “UniLine” group (framed bioprostheses).