Prediction of Surgical Outcome after Aortic Valve Replacement

被引:0
作者
Mistiaen, W. [1 ,2 ]
Van Cauwelaert, Ph. [3 ]
Muylaert, Ph. [3 ]
机构
[1] Artesis Univ Coll Antwerp, Dept Healthcare Sci, Antwerp, Belgium
[2] Univ Antwerp, Fac Med, B-2020 Antwerp, Belgium
[3] ZNA Middelheim Hosp, Antwerp, Belgium
关键词
ELDERLY-PATIENTS; OPERATIVE MORTALITY; HEART-FAILURE; RISK-FACTORS; STENOSIS; EVENTS; DETERMINANTS; SURVIVAL; ANTICOAGULATION; IMPLANTATION;
D O I
10.1080/00015458.2012.11680796
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background : Aortic valve replacement has some major adverse outcomes. For these, the predictors need identification. Methods : This was a retrospective file study of 1000 consecutive patients who underwent AVR for degenerative aortic valve disease. Twenty-five preoperative and 5 peroperative factors were screened by a univariate Fisher-exact analysis. The predictors were identified in a second step by logistic regression multivariate analysis. Results : Five hundred thirty patients were male. The mean age was 75 (71-77) years and 610 also underwent CABG. For hospital mortality, need for urgent aortic valve replacement (p < 0.001) was the dominant predictor. Need for digitalis (p = 0.002) and age > 80 (p = 0.005) followed. For postoperative congestive heart failure, need for urgent aortic valve replacement was also dominant (p < 0.001). Atrial fibrillation (p = 0.001,) and ejection fraction < 50% (p = 0.055) were less important. For ventricular arrhythmia, previous infarction (p = 0.025) and ejection fraction < 50% (p = 0.032) were identified. For bleeding, concomitant CABG (p = 0.046) and chronic obstructive pulmonary disease were identified. For thromboembolic events only an ejection fraction < 50% (p = 0.027) was identified. Conclusions : Need for urgent aortic valve replacement is the dominant predictor for postoperative mortality and congestive heart failure. Once a degenerative aortic valve disease becomes symptomatic, prompt referral could prevent the development for need for urgent surgery, with all its adverse postoperative consequences.
引用
收藏
页码:59 / 64
页数:6
相关论文
共 35 条
  • [1] Alsoufi B, 2006, J HEART VALVE DIS, V15, P12
  • [2] Antiarrhythmic use from 1991 to 2007: Insights from the Canadian Registry of Atrial Fibrillation (CARAF I and II)
    Andrade, Jason G.
    Connolly, Stuart J.
    Dorian, Paul
    Green, Martin
    Humphries, Karin H.
    Klein, George J.
    Sheldon, Robert
    Talajic, Mario
    Kerr, Charles R.
    [J]. HEART RHYTHM, 2010, 7 (09) : 1171 - 1177
  • [3] Variability in treatment advice for elderly patients with aortic stenosis: a nationwide survey in the Netherlands
    Bouma, BJ
    van der Meulen, JHP
    van den Brink, RBA
    Arnold, AER
    Smidts, A
    Teunter, LH
    Lie, KI
    Tijssen, JGP
    [J]. HEART, 2001, 85 (02) : 196 - 201
  • [4] To operate or not on elderly patients with aortic stenosis: the decision and its consequences
    Bouma, BJ
    van den Brink, RBA
    van der Meulen, JHP
    Verheul, HA
    Cheriex, EC
    Hamer, HPM
    Dekker, E
    Lie, KI
    Tijssen, JGP
    [J]. HEART, 1999, 82 (02) : 143 - 148
  • [5] Better anticoagulation control improves survival after valve replacement
    Butchart, EG
    Payne, N
    Li, HH
    Buchan, K
    Mandana, K
    Grunkemeier, GL
    [J]. JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 2002, 123 (04) : 715 - 723
  • [6] Prediction of operative mortality after valve replacement surgery
    Edwards, FH
    Peterson, ED
    Coombs, LP
    DeLong, ER
    Jamieson, WRE
    Shroyer, ALW
    Grover, FL
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2001, 37 (03) : 885 - 892
  • [7] The stentless freestyle bioprosthesis: Impact of age over 80 years on quality of life, perioperative, and mid-term outcome
    Ennker, Juergen
    Dalladaku, Fatmir
    Rosendahl, Ulrich
    Ennker, Ina Carolin
    Mauser, Manfred
    Florath, Ines
    [J]. JOURNAL OF CARDIAC SURGERY, 2006, 21 (04) : 379 - 385
  • [8] Incidence, imaging analysis, and early and late outcomes of stroke after cardiac valve operation
    Filsoufi, Farzan
    Rahmanian, Parwis B.
    Castillo, Javier G.
    Bronster, David
    Adams, David H.
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 2008, 101 (10) : 1472 - 1478
  • [9] Current determinants of operative mortality in 1400 patients requiring aortic valve replacement
    Florath, I
    Rosendahl, UP
    Mortasawi, A
    Bauer, SF
    Dalladaku, F
    Ennker, IC
    Ennker, JC
    [J]. ANNALS OF THORACIC SURGERY, 2003, 76 (01) : 75 - 83
  • [10] Clinically silent cerebral ischemic events after cardiac surgery: Their incidence, regional vascular occurrence, and procedural dependence
    Floyd, TF
    Shah, PN
    Price, CC
    Harris, F
    Ratcliffe, SJ
    Acker, MA
    Bavaria, JE
    Rahmouni, H
    Kuersten, B
    Wiegers, S
    McGarvey, ML
    Woo, JY
    Pochettino, AA
    Melhem, ER
    [J]. ANNALS OF THORACIC SURGERY, 2006, 81 (06) : 2160 - 2166