[Aortic valve replacement: the experiences of 1026 cases].
OBJECTIVE
To study the changes in pathogenic causes and the prognosis of aortic valve replacement (AVR).


METHODS
The clinical data of 1026 patients undergoing AVR from December 1980 to December 2006 were analyzed retrospectively. The mortality, morbidity, changes in pathogenic causes and risk factors were analyzed.


RESULTS
The postoperative mortality and complication morbidity were 4.3% and 10.6% respectively within 30 days followed operation. Main causes of operative death were heart failure, multi organ failure and endocarditis. The major risk factors for operative death were left ventricle ejection fraction less than 0.4, endocarditis, valve regurgitation and emergency operation before AVR. Late mortality was 0.54% patient-year (3.4%), most of whom died of heart failure, endocarditis and arrhythmias. Patients underwent reoperation 0.22% patient-year (1.4%), with the causes of endocarditis and perivalvular fistula.


CONCLUSIONS
Morbidity of rheumatic damage in aortic valve has decreased, while valve degeneration has increased gradually in the recent years. Avoiding prosthesis-patient mismatch, good postoperatively guide and prevention of endocarditis can improve the prognosis of AVR.
Zhang
Bao-ren
BR
Department of Cardiothoracic Surgery, Changhai Hospital of the Second Military Medical University, Shanghai 200433, China.
Xu
Zhi-yun
ZY
Zou
Liang-jian
LJ
Wang
Er-song
ES
Xing
Jian-zhou
JZ
Yu
Wei-yong
WY
Wang
Zhi-nong
ZN
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome