title: Predictors of outcome in a multicenter port-access valve registry.
abstract: BACKGROUND
  The aim of this study was to examine the predictors of outcome in patients undergoing isolated valve operation using port-access techniques.
  
  
  METHODS
  Logistic regression analysis was performed in a prospective, multi-institutional registry of patients undergoing isolated aortic valve replacement (AVR, n = 252), mitral repair (MVP, n = 491), or mitral replacement (MVR, n = 568) using port-access techniques from 1997 to 1999.
  
  
  RESULTS
  Endoaortic balloon occlusion was used in 2% (AVR), 93% (MVP), and 90% (MVR) of cases. Conversion to full sternotomy occurred in 3.8% of all cases. For all patients, early mortality was 50 of 1,311 (3.8%) and onset of new atrial fibrillation occurred in 140 of 1,311 (11%) patients. The determinants of 30-day mortality were redo, age, and MVR or AVR. The determinants of reoperation for bleeding were age, reoperation, and MVR. Age was a predictor for stroke, and age and low or medium volume center were predictors of new atrial fibrillation.
  
  
  CONCLUSIONS
  Excellent short-term results can be obtained using port-access techniques in isolated mitral or aortic valve operations. Patient outcome is not related to institutional case volume, and the primary determinants of outcome after port-access valve procedures are generally patient-related factors.
authors.affiliation: Duke University Medical Center, Durham, North Carolina 27710, USA. glowe001@mc.duke.edu
authors.forename: D D
authors.initials: DD
authors.lastname: Glower
authors.forename: L C
authors.initials: LC
authors.lastname: Siegel
authors.forename: K J
authors.initials: KJ
authors.lastname: Frischmeyer
authors.forename: A C
authors.initials: AC
authors.lastname: Galloway
authors.forename: G H
authors.initials: GH
authors.lastname: Ribakove
authors.forename: E A
authors.initials: EA
authors.lastname: Grossi
authors.forename: N B
authors.initials: NB
authors.lastname: Robinson
authors.forename: W H
authors.initials: WH
authors.lastname: Ryan
authors.forename: S B
authors.initials: SB
authors.lastname: Colvin
mesh_terms: D000367:Age Factors; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001281:Atrial Fibrillation / Q000209:etiology; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D008943:Mitral Valve / Q000601:surgery; D011446:Prospective Studies; D012042:Registries; D012044:Regression Analysis; D012086:Reoperation; D016896:Treatment Outcome