Factors Determining In-Hospital or Late Survival after Aortic Valve Replacement: Late Mortality
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).
With regard to mortality in relation to the patient’s preoperative condition as categorized by the NYHA functional classification, the rate of mortality was significant when comparing class 2 and 3 (p = 0.032) and class 2 and 4 (p-0.02), but not when comparing class 3 and 4 (p — 0.65). canadian pharmacy
Seven deaths were attributable to valve-related events, representing 19 percent (70 percent CL = 12.1, 27.9) of the 37 valve-related complications in 35 patients (Table 3). Details of valve-related events in this group of patients have been documented. Univariate and multivariate logistic regression analyses did not identify an> incremental risk factor for death due to valve-related events. The instantaneous risk of death due to valve-related events, as assessed by hazard function, remained low throughout the follow-up period, peaking after 60 months. Actuarial freedom from death due to valve-related events was 95.3 ±2 percent at 8 .7 years. Actuarial survival of patients w ho experienced valve-related events was 62.6± 10.1 percent at 8.7 years, compared to 55.4 ±7.0 percent for those who did not (p – 0.38).
Figure 3 Long-tei 111 actuarial patient survival is significantly better in patients with isolated AYR (p <^0.001)
Table 3—Mortality Index of Valve-Related Events
|Event||Prevalence||Moi tality (percent)|
|lutiiusic tissue failure||17||1 (6)|
|Infective endocaiditis of valve||11||6 (55)|