Aortic valve replacement for patients with severe aortic stenosis: risk factors and their impact on 30-month mortality.
BACKGROUND
Few studies have reported population-based outcomes for aortic valve replacement patients.


METHODS
Patients with severe aortic valve stenosis who underwent aortic valve replacement with or without concomitant coronary artery bypass graft surgery from January 1, 2003, to December 31, 2005, were included in the study. Statistical models were developed to identify significant risk factors for mortality, to compare survival for patients with and without selected risk factors, and to compare survival to an age- and sex-matched group from US life tables.


RESULTS
There was total of 6,369 patients in the study. The in-hospital and 30-day mortality rates were 3.97% for aortic valve replacement and 5.69% for aortic valve replacement with concomitant coronary artery bypass graft surgery. Significant risk factors for 30-month mortality included concomitant coronary artery bypass graft surgery, advancing age, lower body surface area, emergency status, low ejection fraction, congestive heart failure, previous heart surgery, and several comorbidities. The 64.3% of patients with isolated aortic valve replacement who had neither congestive heart failure, ejection fraction less than 0.40, acute myocardial infarction less than 24 hours, nor hemodynamic instability had a risk-adjusted survival of 89.9% compared with the 90.0% survival rate of the age- and sex-matched general population (p = 0.28).


CONCLUSIONS
For the large number of patients without high-risk conditions, the 30-month survival is essentially as high as that of an age- and sex-matched group of the US population.
Hannan
Edward L
EL
University at Albany, State University of New York, Albany, New York 12144-3456, USA. elh03@health.state.ny.us
Samadashvili
Zaza
Z
Lahey
Stephen J
SJ
Smith
Craig R
CR
Culliford
Alfred T
AT
Higgins
Robert S D
RS
Gold
Jeffrey P
JP
Jones
Robert H
RH
D000368:Aged; D001024:Aortic Valve Stenosis / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors