Role of age, gender and association of CABG on long-term results after aortic valve replacement with a Carpentier-Edwards bioprosthesis in the elderly.
OBJECTIVE
The problem of postoperative sudden death and the effect of age, gender and association of coronary artery bypass grafting were studied after implantation of a bioprosthetic valve in aortic position.


METHODS



METHODS
retrospective investigation during 13 year.


METHODS
general hospital.


METHODS
500 mostly symptomatic patients who received this bioprosthesis had a follow-up of 2,022 patient-year for 499 patients.


METHODS
aortic valve replacement with a Carpentier-Edwards pericardial prosthesis.


METHODS
hospital complications and mortality, long-term mortality with focus on sudden death and its risk factors, valve related complications and other cardiac events.


RESULTS
Within the hospital: atrial fibrillation was the most frequent complication, for which only gender had an effect (p=0.014). The most occurring valve related complications were thrombo-embolic events. Mortality was adversely affected by male gender (p=0.040). Long-term results: thrombo-embolic events were the most important valve related complications. These events and haemorrhage, endocarditis and reoperation rate were not affected by the association of a CABG. Univariate analysis in patients over 73 showed that the need for CABG significantly increased global mortality (p=0.0001), occurrence of cardiac fatality (p=0.0003) and congestive heart failure (p=0.0036). Non-valve related factors seemed most responsible for postoperative sudden death.


CONCLUSIONS
Age, male gender and the association of a CABG remain important determinants for postoperative survival, but not for the occurrence of valve related complications. Sudden death seems not always related to the valve prosthesis, but is as such classified by convention.
Mistiaen
W
W
Laboratories of Anatomy and Embryology, University of Antwerp, Antwerp, Belgium. mistiaen@ruca.ua.ac.be
Van Cauwelaert
Ph
P
Sys
S U
SU
Muylaert
Ph
P
Harrisson
F
F
Bortier
H
H
D017677:Age Distribution; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D002423:Cause of Death; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality*; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome