Transcatheter and Surgical Aortic Valve Replacement Outcomes for Patients with Chronic Heart Failure

Mubashir, Talha; Balogh, Julius; Chaudhry, Rabail; Quiroz, Cooper; Kar, Biswajit; Armas, Ismael A. Salas de; Liang, Yafen; Markham, Travis; Kumar, Rishi; Choi, Warren; Akkanti, Bindu; Gregorič, Igor D.; Williams, George W.; Zaki, John

doi:10.1053/j.jvca.2020.06.082

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…Despite great advances in cardioprotective strategies, surgical techniques and skills, cardiopulmonary bypass techniques, and postoperative management, myocardial injury is still a common complication following cardiopulmonary bypass surgery, inducing myocardial dysfunction and circulatory impairment [ 1 ], arrhythmia, myocardial energy metabolism disturbance, microcirculation disorder, and low cardiac output syndrome (LCOS) [ 2 , 3 ], thus severely threatening the postoperative recovery of patients. The therapeutic management of LCOS includes hemodynamic support with inotropic agents, vasopressors, and circulatory assist devices.…”

Section: Introductionmentioning

confidence: 99%

Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement

et al. 2021

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Background The aim of this study was to explore the effect of levosimendan in patients after heart valve replacement and its influence on postoperative recovery. Material/Methods This prospective study included 185 patients with valvular diseases undergoing conventional valve replacement. Patients were divided into 2 groups using a random number table before surgery. Patients in the levosimendan group were administrated levosimendan intravenous infusion immediately after entering the Intensive Care Unit (ICU). The left ventricular ejection fraction (LVEF), cardiac output, and heart failure-related index, such as B-type natriuretic peptide (BNP) level, were recorded at 1, 3, and 7 days after surgery. The dosage and administration time of dopamine and epinephrine, mechanical ventilation time, ICU length of stay, and postoperative adverse events were recorded. Results Cardiac output and LVEF of patients in the levosimendan group were significantly higher than those in the control group at different time points ( P <0.05), and BNP level was lower than that of the control group ( P <0.0001). Dosage and administration time of dopamine and epinephrine in the levosimendan group were lower than those of the control group ( P <0.0001, P <0.0001, respectively). ICU length of stay and total incidence of postoperative adverse events were lower than those of the control group ( P <0.0001, P =0.002, respectively). Conclusions Levosimendan administration immediately after heart valve replacement effectively improved the heart function of patients, reduced administration of vasoactive drugs, shortened length of ICU stay, reduced incidence of postoperative adverse events, and promoted recovery of patients after surgery.

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Section: Introductionmentioning

confidence: 99%

Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement

et al. 2021

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A Risk Prediction Model for Adverse Events after Surgical Valve Replacement

Lian,

Yao,

Zheng

et al. 2024

Journal of Cardiac Surgery

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Background. Although several risk-predictive models for patients undergoing surgical valve replacement (SVR) have been published, reports on composite endpoints of adverse events in these patients are limited. This study aimed to establish a novel, easy-to-use prognostic prediction model of composite endpoints in patients following SVR. Methods. According to the inclusion criteria, patients with successful SVR were enrolled. Adverse events, including heart failure hospitalization, stroke, major bleeding, uncontrolled infection, secondary surgery, postoperative arrhythmia, and all-cause mortality during follow-up, were tracked. All datasets were randomly divided into the derivation and validation cohorts at a ratio of 7 to 3. Logistic regression analysis was used to screen for independent predictors and construct a nomogram for adverse events. We further presented a calibration curve and decision curve analysis for evaluating prediction models. Results. According to the multivariate logistic regression analyses, three variables were selected for the final predictive model, including platelet-to-lymphocyte ratio, diabetes mellitus, and albumin. A nomogram was then constructed to present the results. The C-index of the model was 0.73 (95% confidence interval: 0.65–0.81) for the derivation cohort and 0.75 (95% confidence interval: 0.64–0.86) for the validation cohort. The calibration curve demonstrated that the results of the nomogram agreed with actual observations (Brier score = 0.09). Conclusions. We developed an effective nomogram to predict the occurrence of composite adverse events in patients following SVR. This model could be used to evaluate the mid-term risks of adverse events as well as provide clinicians and patients with a basis for decision-making.

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Does the Type of Chronic Heart Failure Impact In-Hospital Outcomes for Aortic Valve Replacement Procedures?

Mubashir

Zaki

et al. 2023

Texas Heart Institute Journal

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Background This study assessed in-hospital outcomes of patients with chronic systolic, diastolic, or mixed heart failure (HF) undergoing transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). Methods The Nationwide Inpatient Sample database was used to identify patients with aortic stenosis and chronic HF who underwent TAVR or SAVR between 2012 and 2015. Propensity score matching and multivariate logistic regression were used to determine outcome risk. Results A cohort of 9,879 patients with systolic (27.2%), diastolic (52.2%), and mixed (20.6%) chronic HF were included. No statistically significant differences in hospital mortality were noted. Overall, patients with diastolic HF had the shortest hospital stays and lowest costs. Compared with patients with diastolic HF, the risk of acute myocardial infarction (TAVR odds ratio [OR], 1.95; 95% CI, 1.20–3.19; P = .008; SAVR OR, 1.38; 95% CI, 0.98–1.95; P = .067) and cardiogenic shock (TAVR OR, 2.15; 95% CI, 1.43–3.23; P < .001; SAVR OR, 1.89; 95% CI, 1.42–2.53; P ≤ .001) was higher in patients with systolic HF, whereas the risk of permanent pacemaker implantation (TAVR OR, 0.58; 95% CI, 0.45–0.76; P < .001; SAVR OR, 0.58; 95% CI, 0.40–0.84; P = .004) was lower following aortic valve procedures. In TAVR, the risk of acute deep vein thrombosis and kidney injury was higher, although not statistically significant, in patients with systolic HF than in those with diastolic HF. Conclusion These outcomes suggest that chronic HF types do not incur statistically significant hospital mortality risk in patients undergoing TAVR or SAVR.

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Transcatheter and Surgical Aortic Valve Replacement Outcomes for Patients with Chronic Heart Failure

Cited by 3 publications

References 34 publications

Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement

Prospective Study on the Postoperative Use of Levosimendan After Conventional Heart Valve Replacement

A Risk Prediction Model for Adverse Events after Surgical Valve Replacement

Does the Type of Chronic Heart Failure Impact In-Hospital Outcomes for Aortic Valve Replacement Procedures?

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