Home > Journals > The Journal of Cardiovascular Surgery > Past Issues > The Journal of Cardiovascular Surgery 2012 June;53(3) > The Journal of Cardiovascular Surgery 2012 June;53(3):393-9

CURRENT ISSUE
 

JOURNAL TOOLS

eTOC
To subscribe
Submit an article
Recommend to your librarian
 

ARTICLE TOOLS

Reprints
Permissions

 

  CARDIAC SECTION 

The Journal of Cardiovascular Surgery 2012 June;53(3):393-9

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Minimal influence of traditional surgical risk factors on mortality in contemporary aortic valve replacement

Rescigno G., Aratari C., D’alfonso A., Matteucci S., Capestro F., Pierri M. D., Torracca L.

Cardiac Surgery, Lancisi Hospital, Ospedali Riuniti di Ancona, Ancona, Italy


PDF


AIM: Transcatheter aortic valve implantation is increasingly presented as an alternative to aortic valve replacement in the high risk surgical candidate. We review the outcomes of isolated aortic valve replacement to identify contemporary results of aortic valve replacement in such high risk patients.
METHODS: Retrospective analysis of 846 patients (mean age 68.7±11.8 years) who underwent aortic valve replacement in a single institution from 1999 to 2008. We considered 10 risk factors as follows: female gender (395 patients, 46.7%), age, left ventricular ejection fraction, New York Heart Association Class, preoperative creatinine clearance, body mass index, peripheral vascular disease (49 patients, 5%), cerebrovascular disease (42 patients, 4.9%), chronic obstructive pulmonary disease (87 patients,10.2%), and redo surgery (53 patients, 6.2%).
RESULTS: Twenty-five patients died (2.9%). Age (P=0.032; OR 1.07 per each year increase) was the only significant independent predictor of mortality. Length of stay in the hospital was correlated with age (P<0.0001), New York Heart Association Class (P<0.0001) creatinine clearance (P=0.005) and redo surgery (P=0.006).
CONCLUSION: Contemporary aortic valve replacement is a low risk procedure for most patients. Historical risk factors which have been used to define high risk and inoperability, such as pulmonary disease, reoperations, decreased left ventricular ejection fraction and vascular disease, may not be relevant in the current era. This observation should be considered if such criteria are used to define patients for transcatheter aortic valve implantation.

top of page