Redo surgical aortic valve replacement for bioprosthetic structural valve deterioration.

Autor:	Raschpichler M; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Kiefer P; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Otto W; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Noack T; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Gerber M; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., De Waha S; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Dashkevich A; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Leontyev S; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany., Misfeld M; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany.; Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney, Australia.; Sydney Medical School, University of Sydney, Australia., Borger MA; Leipzig Heart Center, University Clinic of Cardiac Surgery, University of Leipzig, Leipzig, Germany.
Jazyk:	angličtina
Zdroj:	European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery [Eur J Cardiothorac Surg] 2024 Oct 01; Vol. 66 (4).
DOI:	10.1093/ejcts/ezae353
Abstrakt:	Objectives: To compare isolated primary bioprosthetic surgical aortic valve replacement (SAVR) with isolated redo surgical aortic valve replacement (rSAVR) due to structural valve deterioration (SVD). Methods: Clinical data of consecutive patients who underwent primary isolated SAVR and isolated rSAVR due to SVD between 1 January 2011 and 31 December 2022, at Leipzig Heart Center were retrospectively compared with regard to the primary outcome of all-cause mortality or stroke during hospitalization. Secondary outcomes of interest included myocardial infarction, re-exploration for bleeding, and permanent pacemaker implantation. Results: A total of 2620 patients, 39.5% females, with a median EuroSCORE II of 1.7 [interquartile range (IQR) 1.1-2.7] were identified, of which rSAVR was performed in 174 patients (6.6%). Patients undergoing primary SAVR were older (69 vs 67 years of age, P = 0.001) and were less likely to have a history of prior stroke (0.9% vs 4.0%, P = 0.003). Although both all-cause death and death or stroke occurred less often following primary SAVR (0.5% vs 5.8%, and 2.2% vs 6.9%, respectively; P < 0.001), prior surgery was not associated with adverse clinical outcome in multivariable analysis. In a matched comparison of 322 patients, rates of death or stroke did not differ between groups (4.8% for both rSAVR and SAVR, P = 1.0). Conclusions: Although redo surgery for SVD is associated with increased rates of early mortality and stroke by univariate analysis, much of this increased risk can be accounted for by comorbidities. Patients undergoing rSAVR on an elective basis can expect an outcome similar to that of primary SAVR. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu