Predictors of outcome in a multicenter port-access valve registry.
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.
Glower
D D
DD
Duke University Medical Center, Durham, North Carolina 27710, USA. glowe001@mc.duke.edu
Siegel
L C
LC
Frischmeyer
K J
KJ
Galloway
A C
AC
Ribakove
G H
GH
Grossi
E A
EA
Robinson
N B
NB
Ryan
W H
WH
Colvin
S B
SB
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