Francesco Nicolini1, Andrea Agostinelli2, Daniela Fortuna3, Giovanni Andrea Contini2, Davide Pacini4, Davide Gabbieri5, Claudio Zussa6, Florio Pigini7, Rossana De Palma3, Tiziano Gherli8. 1. Cardiac Surgery Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy francesco.nicolini@unipr.it. 2. Cardiac Surgery Unit, Department of Cardio-Nephro-Pulmonary, Parma Hospital, Parma, Italy. 3. Regional Agency for Health and Social Care, Emilia-Romagna Region, Bologna, Italy. 4. Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy. 5. Department of Clinical Surgical Cardiology and Thoraco Vascular, Hesperia Hospital, Modena, Italy. 6. Department of Cardiology and Cardiac Surgery, Villa Maria Cecilia Hospital, Lugo, Italy. 7. Department of Cardiac Surgery, Villa Torri Hospital, Bologna, Italy. 8. Cardiac Surgery Unit, Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
Abstract
OBJECTIVES: There are limited reliable data on the long-term survival of patients operated upon with double-valve surgery (DVS) in the literature. In this study, in-hospital mortality and 5-year survival were determined and the potential risk factors for increased mortality were identified and discussed. METHODS: This is a report of an observational retrospective study of 1167 patients undergoing concomitant aortic and mitral valve surgery from 2002 to 2011. Data were prospectively collected in a regional database from Emilia-Romagna (Italy). RESULTS: The overall in-hospital mortality rate for DVS was 6.9%. Both in-hospital and 1-year mortality were statistically significant between age groups. In-hospital mortality was significantly higher for patients with a smaller body mass index (BMI), for those who had concomitant coronary artery bypass grafting (CABG) and those who received mitral valve replacement (MVR) instead of plasty (MVP). In-hospital and 1-year mortality were highest in patients ≥70 who had implantation of mitral and aortic mechanical valves. There were significant differences in 5-year follow-up survival according to age, BMI and concomitant CABG. The choice of MVR and MVP did not affect 5-year survival. Multivariable analysis showed that patient-related factors appear to be the major determinant of late survival, irrespective of the type of operation or other intraoperative variables. CONCLUSIONS: Advanced age, smaller BMI and concomitant CABG are significant risk factors for mortality in DVS. MVP provided comparable 5-year outcomes with MVR. Multivariable analysis demonstrates that preoperative and clinical patient-related factors are the real burden in the successful treatment of patients undergoing double-valve procedures.
OBJECTIVES: There are limited reliable data on the long-term survival of patients operated upon with double-valve surgery (DVS) in the literature. In this study, in-hospital mortality and 5-year survival were determined and the potential risk factors for increased mortality were identified and discussed. METHODS: This is a report of an observational retrospective study of 1167 patients undergoing concomitant aortic and mitral valve surgery from 2002 to 2011. Data were prospectively collected in a regional database from Emilia-Romagna (Italy). RESULTS: The overall in-hospital mortality rate for DVS was 6.9%. Both in-hospital and 1-year mortality were statistically significant between age groups. In-hospital mortality was significantly higher for patients with a smaller body mass index (BMI), for those who had concomitant coronary artery bypass grafting (CABG) and those who received mitral valve replacement (MVR) instead of plasty (MVP). In-hospital and 1-year mortality were highest in patients ≥70 who had implantation of mitral and aortic mechanical valves. There were significant differences in 5-year follow-up survival according to age, BMI and concomitant CABG. The choice of MVR and MVP did not affect 5-year survival. Multivariable analysis showed that patient-related factors appear to be the major determinant of late survival, irrespective of the type of operation or other intraoperative variables. CONCLUSIONS: Advanced age, smaller BMI and concomitant CABG are significant risk factors for mortality in DVS. MVP provided comparable 5-year outcomes with MVR. Multivariable analysis demonstrates that preoperative and clinical patient-related factors are the real burden in the successful treatment of patients undergoing double-valve procedures.
Authors: Regina Maria de Aquino Xavier; Vitor Manuel Pereira Azevedo; Paulo Henrique Godoy; Arn Migowski; Antonio Luiz Pinho Ribeiro; Rogério Brant Martins Chaves; Marcelo Goulart Correia; Carolina de Aquino Xavier; Lucas de Aquino Hashimoto; Clara Weksler; Nelson Albuquerque Souza E Silva Journal: BMC Cardiovasc Disord Date: 2017-12-28 Impact factor: 2.298
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: Ilija Bilbija; Milos Matkovic; Marko Cubrilo; Nemanja Aleksic; Jelena Milin Lazovic; Jelena Cumic; Vladimir Tutus; Marko Jovanovic; Svetozar Putnik Journal: Int J Environ Res Public Health Date: 2020-10-08 Impact factor: 3.390