{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:04:15Z","timestamp":1760123055446,"version":"3.37.3"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T00:00:00Z","timestamp":1615075200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>\u2002<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>The choice of prosthesis for aortic valve replacement (AVR) in younger patients remains controversial. Stentless AVR was introduced 3 decades ago, with the aim of better haemodynamics and durability than stented xenografts. The objective of this analysis was to compare the long-term outcomes to mechanical prostheses in younger patients (age \u226460 years).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>All adult patients who underwent AVR due to aortic valve stenosis and\/or insufficiency between 1993 and 2002 were identified. After the exclusion of patients with congenital heart defects, aortic dissections and Ross-procedures, 158 patients with stentless valves and 226 patients with bi-leaflet mechanical valves were finally included in this analysis. Sixty-six patient pairs could be included in a propensity matched analysis. Mortality and morbidity including stroke, bleeding, endocarditis and reoperation were analysed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Group baseline characteristics and operative data did not differ significantly after propensity matching. Hospital mortality was 0.0% in the stentless and 1.5% in the mechanical group. Total patient years\/median follow-up was 2029.1\/15.4\u2009years (completeness: 100.0%, range: 0\u201325\u2009years). After 20\u2009years, actuarial survival was 47.0\u2009\u00b1\u20096.4% in the stentless and 53.3\u2009\u00b1\u20096.6% in mechanical group (P\u2009=\u20090.69). Bleeding, endocarditis and stroke occurred rarely and did not differ significantly between groups. After 20\u2009years, actuarial overall freedom-from-reoperation was 45.1\u2009\u00b1\u20098.2% in the stentless group and 90.4\u2009\u00b1\u20094.1% in the mechanical group (P\u2009&amp;lt;\u20090.001). Hospital mortality while reoperation was 7.4% in the stentless group and 0% in the mechanical group (P\u2009=\u20091.0)<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Long-term morbidity and mortality of stentless and mechanical aortic valves were statistically not different besides a significantly higher reoperation rate after stentless AVR combined with a probably higher risk of in-hospital mortality. Thus, mechanical AVR should remain the procedure of choice in younger patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezab090","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T12:39:53Z","timestamp":1612874393000},"page":"276-283","source":"Crossref","is-referenced-by-count":7,"title":["Propensity matched long-term analysis of mechanical versus stentless aortic valve replacement in the younger patient"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5925-4070","authenticated-orcid":false,"given":"Torsten","family":"Christ","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9135-6827","authenticated-orcid":false,"given":"Robin","family":"Borck","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Dushe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon Harald","family":"S\u00fcndermann","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"},{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Centre Berlin, Berlin, Germany"},{"name":"German Center for Cardiovascular Research, Partner Site, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7911-8620","authenticated-orcid":false,"given":"Volkmar","family":"Falk","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"},{"name":"Department of Cardiothoracic and Vascular Surgery, German Heart Centre Berlin, Berlin, Germany"},{"name":"German Center for Cardiovascular Research, Partner Site, Berlin, Germany"},{"name":"Department of Health Science and Technology, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herko","family":"Grubitzsch","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin, Humboldt-Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,3,7]]},"reference":[{"key":"2021080208044279500_ezab090-B1","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/S0735-1097(00)00834-2","article-title":"Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial","volume":"36","author":"Hammermeister","year":"2000","journal-title":"J Am Coll 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