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.
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Andrade, Jason G.
Connolly, Stuart J.
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机构:
Hamilton Gen Hosp, Hamilton, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Connolly, Stuart J.
Dorian, Paul
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h-index: 0
机构:
St Michaels Hosp, Toronto, ON M5B 1W8, Canada
Univ Toronto, Toronto, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Dorian, Paul
Green, Martin
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机构:
Ottawa Heart Inst, Ottawa, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Green, Martin
Humphries, Karin H.
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h-index: 0
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, Canada
Ctr Hlth Evaluat & Outcomes Sci, Vancouver, BC, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Humphries, Karin H.
Klein, George J.
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h-index: 0
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Univ Western Ontario, London, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Klein, George J.
Sheldon, Robert
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h-index: 0
机构:
Univ Calgary, Calgary, AB, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Sheldon, Robert
Talajic, Mario
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h-index: 0
机构:
Univ Montreal, Montreal Heart Inst, Montreal, PQ, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Talajic, Mario
Kerr, Charles R.
论文数: 0引用数: 0
h-index: 0
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Andrade, Jason G.
Connolly, Stuart J.
论文数: 0引用数: 0
h-index: 0
机构:
Hamilton Gen Hosp, Hamilton, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Connolly, Stuart J.
Dorian, Paul
论文数: 0引用数: 0
h-index: 0
机构:
St Michaels Hosp, Toronto, ON M5B 1W8, Canada
Univ Toronto, Toronto, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Dorian, Paul
Green, Martin
论文数: 0引用数: 0
h-index: 0
机构:
Ottawa Heart Inst, Ottawa, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Green, Martin
Humphries, Karin H.
论文数: 0引用数: 0
h-index: 0
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, Canada
Ctr Hlth Evaluat & Outcomes Sci, Vancouver, BC, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Humphries, Karin H.
Klein, George J.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Western Ontario, London, ON, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Klein, George J.
Sheldon, Robert
论文数: 0引用数: 0
h-index: 0
机构:
Univ Calgary, Calgary, AB, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Sheldon, Robert
Talajic, Mario
论文数: 0引用数: 0
h-index: 0
机构:
Univ Montreal, Montreal Heart Inst, Montreal, PQ, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Talajic, Mario
Kerr, Charles R.
论文数: 0引用数: 0
h-index: 0
机构:
St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada
Univ British Columbia, Vancouver, BC V5Z 1M9, CanadaSt Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada