Survival and Long-Term Outcomes of Aortic Valve Replacement in Patients Aged 55 to 65 Years
Bibliographic record
Abstract
Background This study aims to compare the outcomes after aortic valve replacement (AVR) with mechanical and biological valves in middle-aged patients (55–65 years) to determine the impact on long-term mortality and morbidity. Methods A retrospective analysis of 373 patients between 55 and 65 years of age who received a primary AVR with or without concomitant coronary artery bypass graft between April 1995 and March 2014. Propensity matching yielded 118 patient pairs in the mechanical and biological valve cohorts. Results Median follow-up time was 6.9 years. No differences in long-term survival or a composite outcome of stroke, bleeding, and endocarditis (major adverse prosthesis-related event; MAPE) were observed in patients receiving biological versus mechanical valves. Actuarial 15-year survival was 46.4% (95% confidence interval [CI], 28.8–62.3%) in the biological valve group versus 60.6% (95% CI, 47.5–71.4%) in the mechanical valve group (hazard ratio, 1.16 [95%CI, 0.69–1.94], p = 0.58). The 15-year cumulative incidence of MAPE was 53.3% (95% CI, 33.7–69.4%) for biological valves versus 24.5% (95% CI, 16.2–33.8%) for mechanical valves (hazard ratio, 0.65 [95% CI, 0.37–1.14], p = 0.12). The 15-year cumulative incidence of reoperation was higher in the bioprosthetic group (26.0% [95% CI, 14.0–39.8%] vs. 5.4% [95% CI, 2.0–11.4%]; hazard ratio 0.24 [95% CI, 0.09–0.68] p < 0.01). Conclusion There is no difference in survival and MAPE at 15 years between biological and mechanical valves. The risk of reoperation was significantly higher in the biological valve group and may affect valve choice in middle-aged patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".