Fifteen-Year Outcome Trends for Valve Surgery in North America

Lee, Richard; Li, Shuang; Rankin, J. Scott; O’Brien, Sean M.; Gammie, James S.; Peterson, Eric D.; McCarthy, Patrick M.; Edwards, Fred H.

doi:10.1016/j.athoracsur.2010.11.009

Cited by 154 publications

(114 citation statements)

References 29 publications

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“…Indeed, pneumonia is one of the most commonly reported complications following cardiac valve procedures. 13 Prior work has explored hospital-level variability (and risk factors) in HAIs after cardiac surgery. Shih and colleagues 1 used patient characteristics (age, body mass index, cardiovascular disease, smoking status, ejection fraction, dyslipidemia, hypertension, chronic lung disease, immunosuppressive therapy, peripheral arterial disease, diabetes mellitus, congestive heart failure, New York Heart Association class, cardiogenic shock, and anticoagulant usage) to estimate each center's predicted rate of HAI.…”

Section: Discussionmentioning

confidence: 99%

Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

Likosky¹,

Wallace²,

Prager³

et al. 2015

The Annals of Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

Likosky¹,

Wallace²,

Prager³

et al. 2015

The Annals of Thoracic Surgery

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“…Data from The Society of Thoracic Surgeons has reported a twofold increase of mortality in reoperative combined mitral and tricuspid valve surgery, with increasing perioperative morbidity commensurate to the comorbidities present. 13,18,19,21,22 Two important findings in the present study merit further discussion. First, 43% of the patients required intraoperative blood products, with similar rates among the primary and reoperative populations.…”

Section: Discussionmentioning

confidence: 87%

Combined Mitral and Tricuspid Valve Surgery Performed via a Right Minithoracotomy Approach

Mihos¹,

Pineda²,

Davila

et al. 2015

Innovations�(Phila)

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Objective Combined mitral and tricuspid valve surgery is associated with an increased perioperative morbidity and mortality. We evaluated the outcomes of a less invasive right minithoracotomy approach in patients undergoing primary or reoperative double-valve surgery. Methods We retrospectively evaluated 132 consecutive patients with mitral and tricuspid valve disease who underwent double-valve surgery via a right minithoracotomy at our institution between January 2009 and April 2014. Results The cohort included 81 female (61%) and 51 male (39%) patients, with a mean ± SD age of 67 ± 13 years. The mean ± SD preoperative left ventricular ejection fraction, mitral regurgitation grade, and creatinine were 53% ± 12%, 3.8 ± 0.6, and 1.26 ± 1.17, respectively. The patients underwent primary (88%) or reoperative (12%) mitral and tricuspid valve surgery, which consisted of 88 mitral repairs (67%), 44 mitral replacements (33%), 131 tricuspid repairs (99%), and 1 tricuspid replacement (1%). Postoperatively, there were 6 cases of acute kidney injury (5%), 6 reoperations for bleeding (5%), 4 cerebrovascular accidents (3%), and 12 cases of atrial fibrillation (9%). The median intensive care unit length of stay and total hospital lengths of stay were 61 hours (interquartile range, 43–112 hours) and 8 days (interquartile range, 6–13 days), respectively. The in-hospital mortality was 4%. Actuarial survival at 1 and 5 years was 93% and 88%, respectively. Conclusions In patients undergoing primary or reoperative mitral and tricuspid valve surgery, a right minithoracotomy approach is associated with a low perioperative morbidity and good midterm survival.

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“…Double valve surgery accounts for 10% of valve procedures performed in the United States (16). Patients requiring a multiple valve operation have an operative mortality that is more than twice that of single valve operations, which is cited at 9.7% for patients undergoing combined mitral and tricuspid valve surgery, 10.7% for those undergoing aortic and mitral valve surgery, and 13.2% for those underdoing aortic and tricuspid valve surgery (17).…”

Section: Discussionmentioning

confidence: 99%

Outcomes of minimally invasive double valve surgery

et al. 2017

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Background: Double valve surgery is associated with an increased peri-operative morbidity and mortality.A less invasive right thoracotomy approach may be a viable alternative to median sternotomy surgery in these higher-risk patients. Methods: We retrospectively analyzed the baseline demographics, operative characteristics, and postoperative outcomes of patients who underwent minimally invasive double valve surgery between January 2009 and December 2011 at our institution. Results: The cohort consisted of 117 patients, of which 68 (58.1%) were female. The mean age was 73±11 years, and the mean left ventricular ejection fraction was 52±11%. There were 43 (36.8%) patients with a history of congestive heart failure, 45 (38.5%) with chronic obstructive pulmonary disease, and 5 (4.3%) had a history of chronic kidney disease. The patients underwent primary (90.6%) or re-operative (9.4%) double valve surgery, which consisted of 50 (42.7%) aortic valve replacement and mitral valve repair, 31 (26.5%) mitral and tricuspid valve repair, 18 (15.4%) aortic and mitral valve replacement, 17 (14.5%) mitral valve replacement with tricuspid valve repair, and 1 (0.9%) aortic valve replacement with tricuspid valve repair.Post-operatively, there were 40 (34.2%) cases of prolonged ventilation, 9 (7.7%) acute kidney injury, 6 (5.1%) re-operations for bleeding, 1 (0.9%) cerebrovascular accident, and 15 (12.8%) cases of atrial fibrillation. The mean total hospital length of stay was 12±12 days, with an in-hospital mortality of 2 (1.7%).Conclusions: A minimally invasive right thoracotomy approach to primary or re-operative double valve surgery is feasible, may be utilized with acceptable peri-operative morbidity and mortality.

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Fifteen-Year Outcome Trends for Valve Surgery in North America

Cited by 154 publications

References 29 publications

Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

Sources of Variation in Hospital-Level Infection Rates After Coronary Artery Bypass Grafting: An Analysis of The Society of Thoracic Surgeons Adult Heart Surgery Database

Combined Mitral and Tricuspid Valve Surgery Performed via a Right Minithoracotomy Approach

Outcomes of minimally invasive double valve surgery

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