title: Valve structure and survival in sexagenarians having aortic valve replacement for aortic stenosis (+/-aortic regurgitation) with versus without coronary artery bypass grafting at a single US medical center (1993 to 2005).
abstract: The purpose of this study was to determine the effect of simultaneous coronary artery bypass grafting (CABG) and the influence of valve structure on both early and late survival in sexagenarians having aortic valve replacement (AVR) for aortic stenosis (AS) (with or without aortic regurgitation). We analyzed survival and valve structure in 289 sexagenarians having AVR for AS from 1993 through 2005 at Baylor University Medical Center, including 147 (51%) with and 142 (49%) without simultaneous CABG. Of the 282 patients with information available, 13 (4.6%) died within 30 days of operation and 1 additional patient, from 31 to 60 days after operation (5.0% 60-day mortality). Sixty-day mortality was similar (6% and 4%) in the groups with and without simultaneous CABG. A total of 66 patients (23%) died from >60 days up to 13 years postoperatively. The unadjusted survival analysis showed that late survival was not affected by gender (male versus female), aortic valve structure (unicuspid, bicuspid, and quadricuspid versus tricuspid) or preoperative severity of the AS (transvalvular peak pressure gradient >50 mm Hg versus < or =50 mm Hg), or by performance of CABG. The aortic valve was congenitally unicuspid in 10 patients (3%), congenitally bicuspid in 170 (59%), 3-cuspid in 107 (37%), congenitally quadricuspid in 1 patient, and the valve structure was indeterminate in 1 patient. In conclusion, gender, valve structure, preoperative severity of the AS, or performance of simultaneous CABG did not effect unadjusted survival in sexagenarians undergoing AVR for AS.
authors.affiliation: Department of Internal Medicine (Division of Cardiology), Baylor University Medical Center, Dallas, TX, USA. wc.roberts@baylorhealth.edu
authors.forename: William Clifford
authors.initials: WC
authors.lastname: Roberts
authors.forename: Jong Mi
authors.initials: JM
authors.lastname: Ko
authors.forename: Giovanni
authors.initials: G
authors.lastname: Filardo
authors.forename: Albert Carl
authors.initials: AC
authors.lastname: Henry
authors.forename: Robert Frederick
authors.initials: RF
authors.lastname: Hebeler
authors.forename: Edson Hoi-Kam
authors.initials: EH
authors.lastname: Cheung
authors.forename: Gregory John
authors.initials: GJ
authors.lastname: Matter
authors.forename: Baron Lloyd
authors.initials: BL
authors.lastname: Hamman
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D004452:Echocardiography; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D013781:Texas / Q000453:epidemiology