Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement

Peyman Naji, Brian P. Griffin, Joseph F. Sabik, Kenya Kusunose, Fadi Asfahan, Zoran B. Popovic, L. Leonardo Rodriguez, Bruce W. Lytle, Richard A. Grimm, Lars G. Svensson, Milind Y. Desai

Research output: Contribution to journalArticle

Abstract

Background - With improved event-free survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. We sought to (1) identify of the characteristics of patients with severe bioprosthetic PAS undergoing redo AVR, and (2) assess the outcomes of these patients, along with factors associated with adverse outcomes. Methods and Results - We studied 276 patients with severe bioprosthetic PAS (64±16 years, 58% men) who underwent redo-AVR between 2000 and 2012 (excluding mechanical PAS, severe other valve disease, and transcatheter AVR). Society of Thoracic Surgeons score was calculated. Severe PAS was defined as AV area II+ aortic regurgitation. Only 39% had an isolated redo AVR, the rest were combination surgeries (coronary bypass and/or aortic surgeries). At 4.2±3 years, 64 (23%) patients met the composite end point (48 deaths and 19 congestive heart failure admissions, 2.5% 30-day deaths). On multivariable Cox survival analysis, higher Society of Thoracic Surgeons score (hazard ratio, 1.35), higher grades of aortic regurgitation (hazard ratio, 1.29), and higher right ventricular systolic pressure (hazard ratio, 1.3) were associated with worse longer-term outcomes (all P

Original languageEnglish (US)
Pages (from-to)1953-1960
Number of pages8
JournalCirculation
Volume132
Issue number21
DOIs
StatePublished - Nov 24 2015
Externally publishedYes

Fingerprint

Aortic Valve Stenosis
Aortic Valve
Surgical Instruments
Aortic Valve Insufficiency
Ventricular Pressure
Survival Analysis
Reoperation
Disease-Free Survival
Heart Failure
Blood Pressure

Keywords

  • aortic valve replacement and outcomes
  • bioprosthetic aortic stenosis

ASJC Scopus subject areas

  • Physiology (medical)
  • Cardiology and Cardiovascular Medicine

Cite this

Naji, P., Griffin, B. P., Sabik, J. F., Kusunose, K., Asfahan, F., Popovic, Z. B., ... Desai, M. Y. (2015). Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement. Circulation, 132(21), 1953-1960. https://doi.org/10.1161/CIRCULATIONAHA.115.015939

Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement. / Naji, Peyman; Griffin, Brian P.; Sabik, Joseph F.; Kusunose, Kenya; Asfahan, Fadi; Popovic, Zoran B.; Rodriguez, L. Leonardo; Lytle, Bruce W.; Grimm, Richard A.; Svensson, Lars G.; Desai, Milind Y.

In: Circulation, Vol. 132, No. 21, 24.11.2015, p. 1953-1960.

Research output: Contribution to journalArticle

Naji, P, Griffin, BP, Sabik, JF, Kusunose, K, Asfahan, F, Popovic, ZB, Rodriguez, LL, Lytle, BW, Grimm, RA, Svensson, LG & Desai, MY 2015, 'Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement', Circulation, vol. 132, no. 21, pp. 1953-1960. https://doi.org/10.1161/CIRCULATIONAHA.115.015939
Naji, Peyman ; Griffin, Brian P. ; Sabik, Joseph F. ; Kusunose, Kenya ; Asfahan, Fadi ; Popovic, Zoran B. ; Rodriguez, L. Leonardo ; Lytle, Bruce W. ; Grimm, Richard A. ; Svensson, Lars G. ; Desai, Milind Y. / Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement. In: Circulation. 2015 ; Vol. 132, No. 21. pp. 1953-1960.
@article{574db59f5a9b4966bef2e1524a546ff3,
title = "Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement",
abstract = "Background - With improved event-free survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. We sought to (1) identify of the characteristics of patients with severe bioprosthetic PAS undergoing redo AVR, and (2) assess the outcomes of these patients, along with factors associated with adverse outcomes. Methods and Results - We studied 276 patients with severe bioprosthetic PAS (64±16 years, 58{\%} men) who underwent redo-AVR between 2000 and 2012 (excluding mechanical PAS, severe other valve disease, and transcatheter AVR). Society of Thoracic Surgeons score was calculated. Severe PAS was defined as AV area II+ aortic regurgitation. Only 39{\%} had an isolated redo AVR, the rest were combination surgeries (coronary bypass and/or aortic surgeries). At 4.2±3 years, 64 (23{\%}) patients met the composite end point (48 deaths and 19 congestive heart failure admissions, 2.5{\%} 30-day deaths). On multivariable Cox survival analysis, higher Society of Thoracic Surgeons score (hazard ratio, 1.35), higher grades of aortic regurgitation (hazard ratio, 1.29), and higher right ventricular systolic pressure (hazard ratio, 1.3) were associated with worse longer-term outcomes (all P",
keywords = "aortic valve replacement and outcomes, bioprosthetic aortic stenosis",
author = "Peyman Naji and Griffin, {Brian P.} and Sabik, {Joseph F.} and Kenya Kusunose and Fadi Asfahan and Popovic, {Zoran B.} and Rodriguez, {L. Leonardo} and Lytle, {Bruce W.} and Grimm, {Richard A.} and Svensson, {Lars G.} and Desai, {Milind Y.}",
year = "2015",
month = "11",
day = "24",
doi = "10.1161/CIRCULATIONAHA.115.015939",
language = "English (US)",
volume = "132",
pages = "1953--1960",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "21",

}

TY - JOUR

T1 - Characteristics and outcomes of patients with severe bioprosthetic aortic valve stenosis undergoing redo surgical aortic valve replacement

AU - Naji, Peyman

AU - Griffin, Brian P.

AU - Sabik, Joseph F.

AU - Kusunose, Kenya

AU - Asfahan, Fadi

AU - Popovic, Zoran B.

AU - Rodriguez, L. Leonardo

AU - Lytle, Bruce W.

AU - Grimm, Richard A.

AU - Svensson, Lars G.

AU - Desai, Milind Y.

PY - 2015/11/24

Y1 - 2015/11/24

N2 - Background - With improved event-free survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. We sought to (1) identify of the characteristics of patients with severe bioprosthetic PAS undergoing redo AVR, and (2) assess the outcomes of these patients, along with factors associated with adverse outcomes. Methods and Results - We studied 276 patients with severe bioprosthetic PAS (64±16 years, 58% men) who underwent redo-AVR between 2000 and 2012 (excluding mechanical PAS, severe other valve disease, and transcatheter AVR). Society of Thoracic Surgeons score was calculated. Severe PAS was defined as AV area II+ aortic regurgitation. Only 39% had an isolated redo AVR, the rest were combination surgeries (coronary bypass and/or aortic surgeries). At 4.2±3 years, 64 (23%) patients met the composite end point (48 deaths and 19 congestive heart failure admissions, 2.5% 30-day deaths). On multivariable Cox survival analysis, higher Society of Thoracic Surgeons score (hazard ratio, 1.35), higher grades of aortic regurgitation (hazard ratio, 1.29), and higher right ventricular systolic pressure (hazard ratio, 1.3) were associated with worse longer-term outcomes (all P

AB - Background - With improved event-free survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. We sought to (1) identify of the characteristics of patients with severe bioprosthetic PAS undergoing redo AVR, and (2) assess the outcomes of these patients, along with factors associated with adverse outcomes. Methods and Results - We studied 276 patients with severe bioprosthetic PAS (64±16 years, 58% men) who underwent redo-AVR between 2000 and 2012 (excluding mechanical PAS, severe other valve disease, and transcatheter AVR). Society of Thoracic Surgeons score was calculated. Severe PAS was defined as AV area II+ aortic regurgitation. Only 39% had an isolated redo AVR, the rest were combination surgeries (coronary bypass and/or aortic surgeries). At 4.2±3 years, 64 (23%) patients met the composite end point (48 deaths and 19 congestive heart failure admissions, 2.5% 30-day deaths). On multivariable Cox survival analysis, higher Society of Thoracic Surgeons score (hazard ratio, 1.35), higher grades of aortic regurgitation (hazard ratio, 1.29), and higher right ventricular systolic pressure (hazard ratio, 1.3) were associated with worse longer-term outcomes (all P

KW - aortic valve replacement and outcomes

KW - bioprosthetic aortic stenosis

UR - http://www.scopus.com/inward/record.url?scp=84948095223&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84948095223&partnerID=8YFLogxK

U2 - 10.1161/CIRCULATIONAHA.115.015939

DO - 10.1161/CIRCULATIONAHA.115.015939

M3 - Article

C2 - 26358259

AN - SCOPUS:84948095223

VL - 132

SP - 1953

EP - 1960

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 21

ER -