Risk factors for short- and long-term survival in patients undergoing re-replacement due to prosthetic valve dysfunction

Objectives: The aim of this study was to evaluate independent risk factors predictive for mortality of patients with Stanford A acute aortic dissection. Methods: From January 2006 to March 2015, a total of 240 consecutive patients diagnosed with acute Stanford A acute aortic dissection underwent surgical aortic repair in our center. After analysis of pre- and perioperative variables, univariate logistic and multivariate logistic regression analyses were performed for mortality of patients. Subsequently, Kaplan–Meier estimation analysis of short- and long-term survival of these variables was carried out. Results: Primary entry tear in descending aorta (odds ratio = 4.71, p = 0.021), preoperative international normalized ratio higher than 1.2 (odds ratio = 7.36, p = 0.001), additional coronary artery bypass grafting (odds ratio = 3.39, p = 0.003), cannulation in ascending aorta (odds ratio = 3.22, p = 0.005), preoperative neurological coma (odds ratio = 3.30, p = 0.003), and reduced perfusion (odds ratio = 2.91, p = 0.006) as well as prolonged reperfusion time (odds ratio = 3.36, p = 0.002) showed to be independent predictors for early mortality as well as for late mortality (hazard ratio of all variables p < 0.05). Kaplan–Meier survival estimation analysis with up to 9-year-follow-up in terms of these risk factors showed significantly poorer short- and long-term survival (log-rank and Breslow test all p < 0.05). Conclusion: Our study revealed that early and late mortality of patients with Stanford A acute aortic dissection surgery was significantly influenced by preoperative and perioperative variables as independent predictors especially of variables displaying coronary, cerebral, and visceral malperfusion. Also, short- and long-term survival of patients was significantly poorer in terms of these risk factors.

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Early and delayed stroke after coronary surgery — an analysis of risk factors and the impact on short- and long-term survival

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2010.11.060 ◽

2011 ◽

Cited By ~ 7

Author(s):

Magnus Hedberg ◽

Patrik Boivie ◽

Karl Gunnar Engström

Keyword(s):

Risk Factors ◽

Coronary Surgery ◽

Term Survival ◽

Long Term Survival ◽

Short And Long Term ◽

The Impact

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Lead Dependent Tricuspid Valve Dysfunction-Risk Factors, Improvement after Transvenous Lead Extraction and Long-Term Prognosis

Journal of Clinical Medicine ◽

10.3390/jcm11010089 ◽

2021 ◽

Vol 11 (1) ◽

pp. 89

Author(s):

Anna Polewczyk ◽

Wojciech Jacheć ◽

Dorota Nowosielecka ◽

Andrzej Tomaszewski ◽

Wojciech Brzozowski ◽

...

Keyword(s):

Risk Factors ◽

Tricuspid Valve ◽

Lead Extraction ◽

Common Mechanism ◽

Term Survival ◽

Long Term Survival ◽

Valve Dysfunction ◽

Valve Function ◽

Long Term Prognosis

Background: Lead-related tricuspid valve dysfunction (LDTVD) has not been studied in a large population and its management remains controversial. Methods: An analysis of the clinical data of 2678 patients undergoing transvenous lead extraction (TLE) in years 2008–2021 was conducted, with a separate group of 119 patients with LDTVD. Potential risk factors for LDTVD, improvement in valve function, and long-term prognosis after TLE were assessed. Results: LDTVD was diagnosed in 4.44% of patients referred for lead extraction due to different reasons. The most common mechanism of LDTVD was propping upward or clamping down the leaflet by the lead (85.71%). The probability of LDTVD was higher in female sex, patients with valvular heart disease, atrial fibrillation, heart failure, large right ventricle and high pulmonary artery systolic pressure, the presence of only pacing lead, and in case of collision of the lead with tricuspid valve and adhesion of the lead to the heart structures. The prognosis of patients with LDTVD was worse, however, patients with improved valve function after TLE showed a significantly better long-term survival. Conclusions: Lead dependent tricuspid valve dysfunction is a potentially serious condition that requires thorough diagnostics and thoughtful management. The risk factors for LDTVD are primarily related to the course of the lead and its adhesion to the heart structures. Improvement of tricuspid valve function after TLE is observed in 35.29% of patients Patients with LDTVD have a worse long-term survival, but the improvement in valve function following TLE contributes to a significant reduction in mortality.

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Short- and Long-Term Survival of Nonsurgical Intensive Care Patients and its Relation to Diagnosis, Severity of Disease, Age and Comorbidities

Current Aging Science ◽

10.2174/1874609810902030240 ◽

2009 ◽

Vol 2 (3) ◽

pp. 240-248 ◽

Cited By ~ 8

Author(s):

Peter Kaufmann ◽

Karl Smolle ◽

Guenter Krejs

Keyword(s):

Intensive Care ◽

Term Survival ◽

Long Term Survival ◽

Intensive Care Patients ◽

Severity Of Disease ◽

Short And Long Term

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Long-term survival after Carpentier-Edwards Perimount aortic valve replacement in Western Denmark: a multi-centre observational study

Journal of Cardiothoracic Surgery ◽

10.1186/s13019-021-01506-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Lytfi Krasniqi ◽

Mads P. Kronby ◽

Lars P. S. Riber

Keyword(s):

Risk Factors ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Significant Risk ◽

Valve Prosthesis ◽

Term Survival ◽

Long Term Survival ◽

All Cause Mortality

Abstract Background This study describes the long-term survival, risk of reoperation and clinical outcomes of patients undergoing solitary surgical aortic valve replacement (SAVR) with a Carpentier-Edwards Perimount (CE-P) bioprosthetic in Western Denmark. The renewed interest in SAVR is based on the questioning regarding the long-term survival since new aortic replacement technique such as transcatheter aortic-valve replacement (TAVR) probably have shorter durability, why assessment of long-term survival could be a key issue for patients. Methods From November 1999 to November 2013 a cohort of a total of 1604 patients with a median age of 73 years (IQR: 69–78) undergoing solitary SAVR with CE-P in Western Denmark was obtained November 2018 from the Western Danish Heart Registry (WDHR). The primary endpoint was long-term survival from all-cause mortality. Secondary endpoints were survival free from major adverse cardiovascular and cerebral events (MACCE), risk of reoperation, cause of late death, patient-prothesis mismatch, risk of AMI, stroke, pacemaker or ICD implantation and postoperative atrial fibrillation (POAF). Time-to-event analysis was performed with Kaplan-Meier curve, cumulative incidence function was performed with Nelson-Aalen cumulative hazard estimates. Cox regression was applied to detect risk factors for death and reoperation. Results In-hospital mortality was 2.7% and 30-day mortality at 3.4%. The 5-, 10- and 15-year survival from all-cause mortality was 77, 52 and 24%, respectively. Survival without MACCE was 80% after 10 years. Significant risk factors of mortality were small valves, smoking and EuroSCORE II ≥4%. The risk of reoperation was < 5% after 7.5 years and significant risk factors were valve prosthesis-patient mismatch and EuroSCORE II ≥4%. Conclusions Patients undergoing aortic valve replacement with a Carpentier-Edwards Perimount valve shows a very satisfying long-term survival. Future research should aim to investigate biological valves long-term durability for comparison of different SAVR to different TAVR in long perspective.

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