Reintervention rates following bioprosthetic surgical aortic valve replacement-a Danish Nationwide Cohort Study
| Autor: | Kirstine Lærum Sibilitz, Michelle Schmiegelow, Niels Eske Bruun, Lars Køber, Christian L Carranza, Emil L. Fosbøl, Christian Torp-Pedersen, Hanne Elming, Søren S Schmiegelow, Jordi S. Dahl |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve medicine.medical_specialty Denmark Reintervention Danish Cohort Studies Transcatheter Aortic Valve Replacement Aortic valve replacement Risk Factors medicine Endocarditis Humans Mortality Heart Valve Prosthesis Implantation business.industry Bioprosthetic aortic valve replacement Mortality rate General Medicine Aortic Valve Stenosis medicine.disease language.human_language Surgery medicine.anatomical_structure Treatment Outcome Concomitant Aortic Valve Heart Valve Prosthesis language Cardiology and Cardiovascular Medicine business Health economics Cohort study Artery |
| Zdroj: | Schmiegelow, M D S, Elming, H, Sibilitz, K L, Bruun, N E, Carranza, C L, Dahl, J S, Fosbøl, E, Køber, L, Torp-Pedersen, C & Schmiegelow, S S 2022, ' Reintervention rates following bioprosthetic surgical aortic valve replacement-a Danish Nationwide Cohort Study ', European Journal of Cardio-Thoracic Surgery, vol. 61, no. 3, pp. 614-622 . https://doi.org/10.1093/ejcts/ezab365 |
| ISSN: | 1873-734X |
| DOI: | 10.1093/ejcts/ezab365 |
| Popis: | OBJECTIVES Updated European guidelines recommend annual echocardiographic evaluation after bioprosthetic surgical aortic valve replacement (bio-SAVR). Given the increased demand on health care resources, only clinically relevant controls can be prioritized. We therefore aimed to explore reintervention rates following bio-SAVR. METHODS From the nationwide Danish Register of Surgical Procedures, we identified all patients ≥40 years with isolated bio-SAVR ± concomitant coronary artery bypass graft surgery (CABG) during 2000–2016. In 90-day reintervention-free survivors, we assessed aortic valve reintervention rates (primary outcome) and all-cause mortality rates (secondary outcome) at 1, 3 and 5 years with total follow-up until 31 December 2017 and further estimated annual theoretical echocardiographic control visits. RESULTS In 10 518 patients with bio-SAVR (+CABG 39.7%), we observed low reintervention rates at 1, 3 and 5 years, but with high rates of all-cause mortality; i.e. 5-year reintervention rate of 3.7/1000 person-years (≤1.5%) and 5-year mortality rate of 21.7/1000 person-years. Accounting for the competing risk of death, 5-year rates were inversely related to age group and remained relatively low across all age categories but increased gradually in the long term. A significant proportion of reinterventions were presumed due to infectious endocarditis (48% at 3 years, 37% at 5 years). With annual transthoracic echocardiography, the theoretical ratio of echocardiographies per reintervention in the first 5 years was 248, and 425 when endocarditis events were excluded. CONCLUSION Reintervention rates within the first 5 years following bio-SAVR were relatively rare, and with a substantial number due to endocarditis. |
| Databáze: | OpenAIRE |
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