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What Can We Learn from the Past by Means of Very Long-Term Follow-Up after Aortic Valve Replacement?
| Content Provider | MDPI |
|---|---|
| Author | Swinkels, Ben Berg, Jurriën Ten Kelder, Johannes Vermeulen, Freddy van Boven, Wim Jan de Mol, Bas |
| Copyright Year | 2021 |
| Description | Background: Studies on very long-term outcomes after aortic valve replacement are sparse. Methods: In this retrospective cohort study, long-term outcomes during 25.1 ± 2.8 years of follow-up were determined in 673 patients who underwent aortic valve replacement with or without concomitant coronary artery bypass surgery for severe aortic stenosis and/or regurgitation. Independent predictors of decreased long-term survival were determined. Cumulative incidence rates of major adverse events in patients with a mechanical versus those with a biologic prosthesis were assessed, as well as of major bleeding events in patients with a mechanical prosthesis under the age of 60 versus those above the age of 60. Results: Impaired left ventricular function, severe prosthesis–patient mismatch, and increased aortic cross-clamp time were independent predictors of decreased long-term survival. Left ventricular hypertrophy, a mechanical or biologic prosthesis, increased cardiopulmonary bypass time, new-onset postoperative atrial fibrillation, and the presence of symptoms did not independently predict decreased long-term survival. The risk of major bleeding events was higher in patients with a mechanical in comparison with those with a biologic prosthesis. Younger age (under 60 years) did not protect patients with a mechanical prosthesis against major bleeding events. Conclusions: Very long-term outcome data are invaluable for careful decision-making on aortic valve replacement. |
| Starting Page | 3925 |
| e-ISSN | 20770383 |
| DOI | 10.3390/jcm10173925 |
| Journal | Journal of clinical medicine |
| Issue Number | 17 |
| Volume Number | 10 |
| Language | English |
| Publisher | MDPI |
| Publisher Date | 2021-08-31 |
| Access Restriction | Open |
| Subject Keyword | Journal of clinical medicine Journal of Clinical Medicine Peripheral Vascular Disease Valvular Heart Surgery Aortic Valve Replacement Long-term Follow-up Survival Analysis |
| Content Type | Text |
| Resource Type | Article |
