Outcomes of surgical aortic valve replacement over three decades
| Autor: | Andras P. Durko, Jos A. Bekkers, Mevlüt Çelik, Edris A F Mahtab, Ad J.J.C. Bogers, Frans B S Oei |
|---|---|
| Přispěvatelé: | Cardiothoracic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Population 030204 cardiovascular system & hematology Transcatheter Aortic Valve Replacement 03 medical and health sciences 0302 clinical medicine Aortic valve replacement SDG 3 - Good Health and Well-being Risk Factors medicine Humans Myocardial infarction education Aged Retrospective Studies Heart Valve Prosthesis Implantation education.field_of_study Ejection fraction Relative survival business.industry Aortic Valve Stenosis Middle Aged medicine.disease Confidence interval Surgery Treatment Outcome 030228 respiratory system Aortic valve stenosis Aortic Valve Heart Valve Prosthesis Cohort Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Thoracic and Cardiovascular Surgery, 164(6), 1742-1751. Mosby Inc. |
| ISSN: | 1097-685X 0022-5223 1987-1996 |
| Popis: | Objective: The study objective was to analyze temporal changes in baseline and procedural characteristics and long-term survival of patients undergoing surgical aortic valve replacement over a 30-year period. Methods: A retrospective analysis of patients undergoing surgical aortic valve replacement between 1987 and 2016 in the Erasmus Medical Center (Rotterdam, The Netherlands) was conducted. Patient baseline and procedural characteristics were analyzed in periods according to the date of surgical aortic valve replacement (period A: 1987-1996; B: 1997-2006; C: 2007-2016). Survival status was determined using the Dutch National Death Registry. Relative survival was obtained by comparing the survival after surgical aortic valve replacement with the survival of the age-, sex-, and year-matched general population. Results: Between 1987 and 2016, 4404 patients underwent SAVR. From period A to C, the mean age increased from 63.9 ± 11.2 years to 66.2 ± 12.3 years (P < .001), and the prevalence of diabetes mellitus, hypertension, hypercholesterolemia, previous myocardial infarction, and previous stroke at baseline increased (P values for trend for all < .001). The prevalence of concomitant procedures increased from 42.4% in period A to 48.3% in period C (P = .004). Bioprosthesis use increased significantly (18.8% in period A vs 67.1% in period C, P < .001). Mean survival after surgical aortic valve replacement was 13.8 years. Relative survival at 20 years in the overall cohort was 60.4% (95% confidence interval, 55.9-65.2) and 73.8% (95% confidence interval, 67.1-81.1) in patients undergoing isolated primary surgical aortic valve replacement. Conclusions: Patient complexity has been continuously increasing over the last 30 years, yet long-term survival after surgical aortic valve replacement remains high compared with the age-, sex-, and year-matched general population. |
| Databáze: | OpenAIRE |
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