Introduction. Recent national guidelines recommending mitral valve replacement (MVR) for severe secondary mitral regurgitation have resulted in an increased utilization of mitral bioprosthesis. There is a paucity of data on how longitudinal clinical outcomes vary by prosthesis type. We examined long-term survival and risk of reoperation between patients having bovine vs. porcine MVR. Study Design. A retrospective analysis of MVR or MVR + coronary artery bypass graft (CABG) from 2001 to 2017 among seven hospitals reporting to a prospectively maintained clinical registry was conducted. The analytic cohort included 1,284 patients undergoing MVR (801 bovine and 483 porcine). Baseline comorbidities were balanced using 1 : 1 propensity score matching with 432 patients in each group. The primary end point was all-cause mortality. Secondary end points included in-hospital morbidity, 30-day mortality, length of stay, and risk of reoperation. Results. In the overall cohort, patients receiving porcine valves were more likely to have diabetes (19% bovine vs. 29% porcine; ), COPD (20% bovine vs. 27% porcine; ), dialysis or creatinine >2 mg/dL (4% bovine vs. 7% porcine; ), and coronary artery disease (65% bovine vs. 77% porcine; ). There was no difference in stroke, acute kidney injury, mediastinitis, pneumonia, length of stay, in-hospital morbidity, or 30-day mortality. In the overall cohort, there was a difference in long-term survival (porcine HR 1.17 (95% CI: 1.00–1.37; )). However, there was no difference in reoperation (porcine HR 0.56 (95% CI: 0.23–1.32; )). In the propensity-matched cohort, patients were matched on all baseline characteristics. There was no difference in postoperative complications or in-hospital morbidity and 30-day mortality. After 1 : 1 propensity score matching, there was no difference in long-term survival (porcine HR 0.97 (95% CI: 0.81–1.17; )) or risk of reoperation (porcine HR 0.54 (95% CI: 0.20–1.47; )). Conclusions. In this multicenter analysis of patients undergoing bioprosthetic MVR, there was no difference in perioperative complications and risk of reoperation of long-term survival after matching.

中文翻译：

---

牛与猪二尖瓣置换术的长期结果：多中心分析

简介。最近的国家指南建议对严重继发性二尖瓣反流进行二尖瓣置换术（MVR），这导致二尖瓣生物假体的利用率增加。关于纵向临床结果如何因假体类型而变化的数据很少。我们研究了牛与猪 MVR 患者的长期生存率和再次手术风险。学习规划。对 2001 年至 2017 年向前瞻性维护的临床登记中心报告的七家医院进行了 MVR 或 MVR + 冠状动脉旁路移植术 (CABG) 的回顾性分析。分析队列包括 1,284 名接受 MVR 的患者（801 名牛和 483 名猪）。使用与每组 432 名患者进行 1:1 倾向评分匹配来平衡基线合并症。主要终点是全因死亡率。次要终点包括院内发病率、30 天死亡率、住院时间和再次手术风险。结果。在整个队列中，接受猪瓣膜的患者更有可能患有糖尿病（牛瓣膜为 19%，猪为 29%；）、慢性阻塞性肺病（20% 牛 vs. 27% 猪；)、透析或肌酐 >2 mg/dL（4% 牛 vs. 7% 猪；）和冠状动脉疾病（牛为 65%，猪为 77%；）。中风、急性肾损伤、纵隔炎、肺炎、住院时间、住院发病率或 30 天死亡率没有差异。在整个队列中，长期生存率存在差异（猪 HR 1.17（95% CI：1.00–1.37；））。然而，再次手术没有差异（猪 HR 0.56（95% CI：0.23–1.32；））。在倾向匹配队列中，患者的所有基线特征都进行了匹配。术后并发症或院内发病率和 30 天死亡率没有差异。经过1:1倾向评分匹配后，长期生存率没有差异（猪HR 0.97（95% CI：0.81-1.17；））或再次手术的风险（猪 HR 0.54（95% CI：0.20–1.47；））。结论。在这项对接受生物假体 MVR 的患者进行的多中心分析中，围手术期并发症和匹配后长期生存的再次手术风险没有差异。