Aortic Valve Replacement for Patients With Severe Aortic Stenosis

Risk Factors and Their Impact on 30-Month Mortality

Edward L. Hannan, Zaza Samadashvili, Stephen J. Lahey, Craig R. Smith, Alfred T. Culliford, Robert Higgins, Jeffrey P. Gold, Robert H. Jones

Research output: Contribution to journalArticle

Abstract

Background: Few studies have reported population-based outcomes for aortic valve replacement patients. Methods: Patients with severe aortic valve stenosis who underwent aortic valve replacement with or without concomitant coronary artery bypass graft surgery from January 1, 2003, to December 31, 2005, were included in the study. Statistical models were developed to identify significant risk factors for mortality, to compare survival for patients with and without selected risk factors, and to compare survival to an age- and sex-matched group from US life tables. Results: There was total of 6,369 patients in the study. The in-hospital and 30-day mortality rates were 3.97% for aortic valve replacement and 5.69% for aortic valve replacement with concomitant coronary artery bypass graft surgery. Significant risk factors for 30-month mortality included concomitant coronary artery bypass graft surgery, advancing age, lower body surface area, emergency status, low ejection fraction, congestive heart failure, previous heart surgery, and several comorbidities. The 64.3% of patients with isolated aortic valve replacement who had neither congestive heart failure, ejection fraction less than 0.40, acute myocardial infarction less than 24 hours, nor hemodynamic instability had a risk-adjusted survival of 89.9% compared with the 90.0% survival rate of the age- and sex-matched general population (p = 0.28). Conclusions: For the large number of patients without high-risk conditions, the 30-month survival is essentially as high as that of an age- and sex-matched group of the US population.

Original languageEnglish (US)
Pages (from-to)1741-1749
Number of pages9
JournalAnnals of Thoracic Surgery
Volume87
Issue number6
DOIs
StatePublished - Jun 2009
Externally publishedYes

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Aortic Valve Stenosis
Aortic Valve
Mortality
Coronary Artery Bypass
Survival
Transplants
Research Design
Heart Failure
Population
Life Tables
Body Surface Area
Statistical Models
Thoracic Surgery
Comorbidity
Emergencies
Survival Rate
Hemodynamics
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery
  • Pulmonary and Respiratory Medicine

Cite this

Aortic Valve Replacement for Patients With Severe Aortic Stenosis : Risk Factors and Their Impact on 30-Month Mortality. / Hannan, Edward L.; Samadashvili, Zaza; Lahey, Stephen J.; Smith, Craig R.; Culliford, Alfred T.; Higgins, Robert; Gold, Jeffrey P.; Jones, Robert H.

In: Annals of Thoracic Surgery, Vol. 87, No. 6, 06.2009, p. 1741-1749.

Research output: Contribution to journalArticle

Hannan, Edward L. ; Samadashvili, Zaza ; Lahey, Stephen J. ; Smith, Craig R. ; Culliford, Alfred T. ; Higgins, Robert ; Gold, Jeffrey P. ; Jones, Robert H. / Aortic Valve Replacement for Patients With Severe Aortic Stenosis : Risk Factors and Their Impact on 30-Month Mortality. In: Annals of Thoracic Surgery. 2009 ; Vol. 87, No. 6. pp. 1741-1749.
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