Factors Determining In-Hospital or Late Survival after Aortic Valve Replacement: Survival of Valve
Survival 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
Several factors have influenced the prognosis of patients undergoing AVR during the last decade. Positive factors include the introduction of cardioplegia and the availability of tissue valves with good hydraulic and low thromboembolic characteristics.^ On the other hand, the increasing number of elderly patients referred for AVR has impacted the results of AVR. Therefore, a reassessment of factors determining in-hospital or late survival of patients after AVR is timely. The present study was intended to evaluate the influence of these contemporaneous factors on the survival of patients following AVR. The primary end-point of this study was to identify factors affecting in-hospital or late survival of patients. This, as a corollary, necessitated evaluation of the pericardial valve with regard to valve-related events and their influences on survival. This has been addressed as a secondary end point.
Of importance in this type of evaluation is the length (>8 to 9 years) and completeness (100 percent) of follow-up to identify perceivable events, as is the ev aluation in a rather homogeneous group undergoing AVR with one type of prosthesis.
This study revealed an in-hospital mortality of less than 5 percent for isolated AVR; that of the entire group, including patients with concomitant procedures, was 7 percent (16/240).