OBJECTIVE: This retrospective study was designed to assess the early morbidity and mortality as well as long-term mortality of combined aortic-mitral valve procedures at a single centre. METHODS: Patients were identified by analysing the intensive care and perfusion databases, from 1989 to 2003, with 113 receiving aortic-mitral valve procedures. Eighty-four percent of patients received a mechanical bileaflet valve. Survival was assessed using a Kaplan-Meier method, and determinants of survival with the Cox proportional hazards model. RESULTS: There were 57 men and 56 women, median age 59 (18-84) years. The 30-day mortality was 9% (n=10). This cohort contained a number of high risk patients, 38% were classified as New York Heart Association class IV, 33.5% had at least moderate ventricular impairment, 20% were redo procedures and 17% urgent procedures. Survival estimates at 5 and 10 years were 85% (0.76-0.90) and 65% (0.49-0.77), respectively. Multivariate pre-operative predictors of death included renal dysfunction (creatinine >200 micromol/L) and hypertension. Rheumatic aetiology was associated with improved survival. CONCLUSION: This study shows acceptable short and long-term survival in patients undergoing combined aortic-mitral valve surgical procedures at a single centre. Renal impairment and hypertension were associated with a poorer long-term prognosis and rheumatic aetiology was associated with improved survival. Age, LVEF and NYHA class were not associated with a worse outcome. This may affect future decision making in light of an aging population.
OBJECTIVE: This retrospective study was designed to assess the early morbidity and mortality as well as long-term mortality of combined aortic-mitral valve procedures at a single centre. METHODS:Patients were identified by analysing the intensive care and perfusion databases, from 1989 to 2003, with 113 receiving aortic-mitral valve procedures. Eighty-four percent of patients received a mechanical bileaflet valve. Survival was assessed using a Kaplan-Meier method, and determinants of survival with the Cox proportional hazards model. RESULTS: There were 57 men and 56 women, median age 59 (18-84) years. The 30-day mortality was 9% (n=10). This cohort contained a number of high risk patients, 38% were classified as New York Heart Association class IV, 33.5% had at least moderate ventricular impairment, 20% were redo procedures and 17% urgent procedures. Survival estimates at 5 and 10 years were 85% (0.76-0.90) and 65% (0.49-0.77), respectively. Multivariate pre-operative predictors of death included renal dysfunction (creatinine >200 micromol/L) and hypertension. Rheumatic aetiology was associated with improved survival. CONCLUSION: This study shows acceptable short and long-term survival in patients undergoing combined aortic-mitral valve surgical procedures at a single centre. Renal impairment and hypertension were associated with a poorer long-term prognosis and rheumatic aetiology was associated with improved survival. Age, LVEF and NYHA class were not associated with a worse outcome. This may affect future decision making in light of an aging population.
Authors: Sarah E Siegelaar; Maartje Hickmann; Joost B L Hoekstra; Frits Holleman; J Hans DeVries Journal: Crit Care Date: 2011-09-13 Impact factor: 9.097
Authors: Pey-Jen Yu; Allan Mattia; Hugh A Cassiere; Rick Esposito; Frank Manetta; Nina Kohn; Alan R Hartman Journal: J Cardiothorac Surg Date: 2017-12-29 Impact factor: 1.637
Authors: Maximilian Kreibich; Klaus Kaier; Constantin von Zur Mühlen; Matthias Siepe; Manfred Zehender; Christoph Bode; Friedhelm Beyersdorf; Peter Stachon; Wolfgang Bothe Journal: Interact Cardiovasc Thorac Surg Date: 2022-02-21