Aortic Valve Replacement for Patients With Severe Aortic Stenosis: Risk Factors and Their Impact on 30-Month Mortality

Hannan, Edward L.; Samadashvili, Zaza; Lahey, Stephen J.; Smith, Craig R.; Culliford, Alfred T.; Higgins, Robert S.D.; Gold, Jeffrey P.; Jones, Robert H.

doi:10.1016/j.athoracsur.2009.02.058

Cited by 35 publications

(18 citation statements)

References 19 publications

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“…In those requiring aortic valve replacement (AVR), for either aortic stenosis or aortic regurgitation, a reduced left ventricular ejection fraction is one of the most significant risk factors of early and late mortality (2,3). In addition, clinically significant mitral regurgitation may coexist in up to 35% of this population, which often necessitates a double valve operation (4).…”

Section: Introductionmentioning

confidence: 99%

Aortic valve replacement in patients with a left ventricular ejection fraction ≤35% performed via a minimally invasive right thoracotomy

Santana¹,

Xydas²,

Williams³

et al. 2017

J. Thorac. Dis.

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Background: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. Results: There were 75 patients identified: 51 who underwent isolated AVR, and 24 who had combined AVR plus MV surgery for moderate to severe mitral regurgitation. In patients undergoing MV surgery, there were 22 (91.7%) MV repairs [ring annuloplasty =7 (37.5%), transaortic edgeto-edge repair =15 (62.5%)], and 2 (8.3%) replacements. No patient required conversion to sternotomy for inadequate surgical field exposure. The median total mechanical ventilation time and intensive care unit length of stay were 14 (IQR,(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and 42 hours (IQR, in the isolated AVR group, and 16.5 hours (IQR, 12-61.5 hours) and 95.5 hours (IQR, in the AVR plus MV surgery group, respectively. The most common post-operative complication was newonset atrial fibrillation, which occurred in 15 (29.4%) isolated AVR and 4 (16.7%) AVR plus MV surgery patients. The median hospital length of stay and 30-day mortality was 7 days (IQR, 5-12 days) and 1 (2%) in the isolated AVR group, and 10.5 days (IQR, 5-21 days) and 1 (4.3%) for AVR plus MV surgery. Conclusions:In patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35%, minimally invasive AVR can be performed, with or without concomitant MV surgery, with a low morbidity and mortality.

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Section: Introductionmentioning

confidence: 99%

Aortic valve replacement in patients with a left ventricular ejection fraction ≤35% performed via a minimally invasive right thoracotomy

Santana¹,

Xydas²,

Williams³

et al. 2017

J. Thorac. Dis.

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“…When comparing our results with one of the greatest records ever published by AS, the registry of New York, published in 2009 by Hannan et al [9], which gathered 6,369 patients, we realize that our median survival of 30 months of 78.80% in patients undergoing valve replacement alone was slightly lower than that found in this study in patients above 75 years (86.2 %), a rate equivalent to other published studies [16][17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that although the postoperative morbidity is higher in patients over 80 years, the late postoperative mortality is similar to younger patients, with 2-year survival comparable to that of the general population, matched for age and gender [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Results of aortic valve surgery in patients over 75 years old, at 4.5 years of follow-up

Tagliari¹,

Júnior²,

Valle³

et al. 2012

Rev Bras Cir Cardiovasc

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“…(16,17) This, however, contrasted to the findings of a large New York study population of over 6 300 patients which found lower body surface area, which may or may not be linked to female sex, as a risk factor for medium term mortality following AVR. (18) Factors such as body fat composition, which may delay healing, as well as the postmenopausal state, which may confer an increased risk to death following surgery, have been postulated. (19) Although hyperlipidemia was identified as a statistically significant risk factor for mortality (p=0.05), this should be a cautious interpretation considering the small sample size represented only 3 patients overall who had accompanying hyperlipidemia.…”

Section: Discussionmentioning

confidence: 99%

Outcomes following aortic valve replacement for isolated aortic stenosis with left ventricular dysfunction

Naicker

Brown

Ponnusamy

2017

SAHJ

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Outcomes following aortic valve replacement for isolated aortic stenosis with left ventricular dysfunction study was to determine the effects of AVR on left ventricular function and to describe the clinical outcomes in patients with isolated severe AS and LVD. The hypothesis was that AVR in patients with isolated AS and LVD improves LV function. MATERIALS AND METHODS Study populationBetween 2004 and 2013, 1 573 chart records were analysed from the medical database of Inkosi Albert Luthuli Central Hospital, utilising the ICD-9 coding of AVR and AS. These ABSTRACT OUTCOMES FOLLOWING AVR INTRODUCTIONSevere aortic stenosis (AS) is associated with a poor prognosis in patients with left ventricular dysfunction (LVD). Survival is estimated at less than 2 years in patients without aortic valve replacement (AVR).(1,2) A reduced ejection fraction may be related to the severity of the AS and chronic pressure overload of the left ventricle, rather than depressed myocardial contractility (afterload mismatch). Relief of the valvular obstruction, by valve replacement, should allow recovery of left ventricular size and function.(3,4) However, there is a greater surgical risk and morbidity in patients with AS and LVD, which need to be considered. (5,6) Most studies that have described the effects of AVR on ventricular function included patients with coronary artery disease (CAD), which may contribute independently to LVD. Since the presence of CAD is associated with a reduced survival rate following AVR, (2) we aimed to eliminate this variable and evaluate the isolated effect of AVR in those without concomitant CAD. There is no known published data available on survival, changes in ventricular function and long-term follow up from any South African institute to date. The purpose of this

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Aortic Valve Replacement for Patients With Severe Aortic Stenosis: Risk Factors and Their Impact on 30-Month Mortality

Cited by 35 publications

References 19 publications

Aortic valve replacement in patients with a left ventricular ejection fraction ≤35% performed via a minimally invasive right thoracotomy

Aortic valve replacement in patients with a left ventricular ejection fraction ≤35% performed via a minimally invasive right thoracotomy

Results of aortic valve surgery in patients over 75 years old, at 4.5 years of follow-up

Outcomes following aortic valve replacement for isolated aortic stenosis with left ventricular dysfunction

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