Category: Aortic Valve Replacement

Factors Determining In-Hospital or Late Survival after Aortic Valve Replacement: ConclusionThe p value became significant at 8.7 years, in contrast to a previous analysis in which actuarial survival was the same at six years. In addition, there was a significant difference in survival between patients with advanced age or advanced functional class when compared with people younger than 62 years of age or in class 1 and class 2. my canadian pharmacy online

Although the instantaneous risk of death due to valve-related events is constant and low, this series emphasizes that these patients enjoy a good quality of life up to 70 months following implantation. Thereafter, an increased instantaneous risk of valve-related events and late death is present, suggesting important degenerative changes in the leaflets have taken place, with a concurrent increase in valve-related events that may influence late mortality. …Read the rest of this article

Myocardial protection, even with the use of crystalloid cardioplegia, was not complete, as the most common cause of in-hospital mortality was either low’ cardiac output or myocardial infarction. This is particularly true in the initial experiences, when the recently introduced hyperka-lemic crystalloid cardioplegia was used as a single dose, even in those procedures necessitating prolonged aortic cross-clamp time. Incremental risk factors for in-hospital mortality were age over 60 years, advanced preoperative NYHA functional classification, and early year of operation. Early year of operation represents a learning curve in effective cardioplegic myocardial protection.
…Read the rest of this article

Factors Determining In-Hospital or Late Survival after Aortic Valve Replacement: Survival of ValveSurvival of Valve
Intrinsic tissue failure compromised function of the bioprosthetic valve in 17 patients (8 percent or 17/224) (70 percent CL = 5.8, 9.9) at 32 to 91 months after implantation in patients 23 to 77 years of age (mean, 54.6 years) at the time of implantation. Actuarial surv ival from intrinsic valve tissue survival was 78.1 ± 6.8 percent at 8.7 years. The pathologic findings have been reported. Actuarial survival among patients with intrinsic tissue failure was conversely better than those without (87.5 ±8.6 percent and 55.2 ±6 percent at 8.7 years, respectively) (p = 0.002). other
…Read the rest of this article

Actuarial survival of patients, including in-hospital mortality, when plotted, depicted a significantly better survival at 8.7 years for patients who had undergone isolated AVR than those who had a concomitant procedure (p^O.OOl) (Fig 3). Moreover, even when patients with isolated AVR were compared with those whose concomitant procedure was solely one to three concomitant coronary artery bypasses, actuarial survival at 8.7 years was 65.7 ± 6.9 percent and 58.9 ± 8.8 percent, respectively (p = 0.043). Comparing actuarial survival of patients under 60 years of age with those GO years and over, actuarial survival was 75.9 ±6.5 percent and 44.3 ±8.1 percent, respectively (p^ 0.0001). …Read the rest of this article

Factors Determining In-Hospital or Late Survival after Aortic Valve Replacement: ResultsCauses of in-hospital mortality have been tabulated (Table 1). Univariate logistic regression analysis identified age over 60 years (p = 0.015) and advanced preoperative NYHA functional class (3 and 4) (p = 0.003) as incremental risk factors affecting inhospital survival. Incremental risk factors by multivariate analysis were age over 60 years (p = 0.038), advanced preoperative NYHA functional class (p = 0.018), and earlier year of operation (p = 0.049). …Read the rest of this article

Collection of Data and Statistical Analyses
Preliminary data on all patients was gathered retrospectively from patients’ hospital records and questioning patients. The condition of patients has been ascertained yearly since 1981. This was accomplished by examination of the patient by the cardiologist or cardiac surgeon (or both) and by telephone interview with the patient or with the referring physician (or both). No patient was lost to follow-up. The data have been computerized. canadian pharmacy
…Read the rest of this article

myocardial infarction, cardioplegia, aortic cross-clamp time, aortic valve replacementTo determine factors affecting in-hospital or late survival of patients following AVR, a retrospective analysis was undertaken in a group of patients undergoing AVR with a single type of valve substitute. The findings are the basis of this presentation.
Two hundred and forty patients underwent AVR between February 1977 and December 1983. There were 147 male and 93 female patients (1.6:1 ratio), ranging in age from 17 to 86 years of age. The predominant valvular lesion was aortic stenosis in 155 patients (65 percent), aortic regurgitation in 40 patients (17 percent), and a mixed valvular lesion in 45 patients (19 percent). When categorized according to the criteria set forth by the NYHA, three patients were in class 1 (1 percent), 73 patients (30 percent) in class 2, 129 patients (54 percent) in class 3, and 35 patients (15 percent) in class 4. …Read the rest of this article