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Bi-National Outcomes of Redo Surgical Aortic Valve Replacement in the Era of Valve-in-Valve Transcatheter Aortic Valve.
Flynn, Campbell D; Tran, Lavinia; Reid, Christopher M; Almeida, Aubrey; Marasco, Silvana F.
Afiliación
  • Flynn CD; Epworth Hospital, Melbourne, Vic, Australia; School of Medicine, The University of Sydney, Sydney, NSW, Australia.
  • Tran L; School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic, Australia.
  • Reid CM; School of Public Health & Preventive Medicine, Monash University, Melbourne, Vic, Australia; School of Population Health, Curtin University, Perth, WA, Australia.
  • Almeida A; Epworth Hospital, Melbourne, Vic, Australia.
  • Marasco SF; Epworth Hospital, Melbourne, Vic, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Vic, Australia; Department of Cardiothoracic Surgery, The Alfred Hospital, Melbourne, Vic, Australia. Electronic address: s.marasco@alfred.org.au.
Heart Lung Circ ; 33(10): 1432-1438, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39209619
ABSTRACT

BACKGROUND:

Implantation of bioprosthetic valves is more common as the population ages and there is a shift towards implanting bioprosthetic aortic valves in an increasingly younger surgical population. Bioprosthetic heart valve insertion, however, carries the long-term risk of valve failure through structural valve degeneration. Re-operative surgical aortic valve replacement has historically been the only definitive management option for patients with prosthetic valve dysfunction, however, data on the short- and long-term outcomes following re-operative surgery in Australia and New Zealand is limited.

METHOD:

Data on all patients who underwent redo aortic valve surgery, over a 20-year period (up to 2021) was obtained from the Australian and New Zealand Society of Cardiothoracic Surgery Registry.

RESULTS:

A total of 1,199 patients (770 males; 64.2% and 429 females; 35.8%) were included in the overall analysis. The 30-day mortality was 6.4% with operative urgency status the most important risk factor for peri-operative mortality. The long-term survival rate of 1,145 patients was 90.5% (95% confidence interval [CI] 88.8%-92.3%), 77% (95% CI 73.9%-80.2%) and 57.2% (95% CI 55.2%-62.8%) at 1-, 5- and 10-years post-procedure, respectively, with a median survival of 12.7 years. Pre-existing chronic kidney disease was strongly associated with poorer long-term survival. For patients under 70 years of age the 1-, 5- and 10-year survival rates were 92.9% (95% CI 90.9%-95.1%), 83.6% (95% CI 80.1%-87.3%) and 73.1% (95% CI 67.4%-79.3%), respectively.

CONCLUSIONS:

The results from this registry study indicate that in Australia and New Zealand, a repeat surgical aortic valve replacement can result in a relatively low mortality rate, serving as a reference point for medical procedures in these regions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Reoperación / Bioprótesis / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Oceania Idioma: En Revista: Heart Lung Circ Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Válvula Aórtica / Reoperación / Bioprótesis / Reemplazo de la Válvula Aórtica Transcatéter Límite: Aged / Aged80 / Female / Humans / Male País/Región como asunto: Oceania Idioma: En Revista: Heart Lung Circ Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Australia