The Ross procedure versus mechanical aortic valve replacement in young patients: a decision analysis
| Autor: | Harindra C. Wijeysundera, Maral Ouzounian, Derrick Y. Tam, Stephen E. Fremes |
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| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male Reoperation medicine.medical_specialty Adolescent medicine.medical_treatment Aortic Valve Insufficiency 030204 cardiovascular system & hematology Transplantation Autologous Decision Support Techniques 03 medical and health sciences 0302 clinical medicine Postoperative Complications Aortic valve replacement parasitic diseases Medicine Humans Postoperative Period Propensity Score Retrospective Studies Heart Valve Prosthesis Implantation Ontario business.industry Mortality rate Ross procedure Incidence Mechanical Aortic Valve General Medicine Perioperative Middle Aged medicine.disease Surgery Survival Rate medicine.anatomical_structure Treatment Outcome 030228 respiratory system Aortic Valve Propensity score matching Life expectancy Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 55(6) |
| ISSN: | 1873-734X |
| Popis: | OBJECTIVES Our goal was to determine the range of perioperative mortality rates associated with the Ross procedure that results in a life expectancy similar to that seen with mechanical aortic valve replacement (mAVR) in young patients with aortic valve disease. METHODS A fully probabilistic Markov microsimulation model with 1000 outer loops and 10 000 inner loops was constructed to compare gain in life expectancy and quality-adjusted life years between the index treatment with the Ross procedure versus mAVR for a theoretical cohort of young patients with aortic valve disease. Inputs for early deaths and late complications (death, stroke, bleeding, reoperation) were obtained from a single-centre study of 208 propensity score matched patients. In the primary analysis, the perioperative mortality rate for the Ross procedure was varied by increments of 0.5% to determine its impact on life expectancy and quality-adjusted life years. A 2-way sensitivity analysis was conducted to determine simultaneously the impact of the Ross reoperation rate and Ross reoperative mortality rate on life expectancy. RESULTS Life expectancy was improved with the Ross procedure when the perioperative mortality rate with the Ross procedure was |
| Databáze: | OpenAIRE |
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