scholarly journals Repeat aortic valve surgery: contemporary outcomes and risk stratification

2020 ◽  
Author(s):  
Katrien François ◽  
Laurent De Backer ◽  
Thomas Martens ◽  
Tine Philipsen ◽  
Yves Van Belleghem ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Coronary Disease ◽  
Female Gender ◽  
Early Mortality ◽  
Valve Surgery ◽  
Interquartile Range ◽  
Aortic Valve Surgery ◽  
Valve Dysfunction ◽  
Transcatheter Valve

Abstract OBJECTIVES Redo aortic valve surgery (rAVS) is performed with increasing frequency, but operative mortality is usually higher compared to that associated with primary aortic valve surgery. We analysed our patients who had rAVS to determine the current outcomes of rAVS as a surgical benchmark in view of the growing interest in transcatheter valve techniques. METHODS We retrospectively reviewed 148 consecutive patients [median age 67.7 years (interquartile range 54.9–77.6); 68.2% men] who underwent rAVS following aortic valve replacement (81.6%), aortic root replacement (15%) or aortic valve repair (3.4%) between 2000 and 2018. RESULTS Indications for rAVS were structural valve dysfunction (42.7%), endocarditis (37.8%), non-structural valve dysfunction (17.7%) and aortic aneurysm (2.1%). Valve replacement was performed in 69.7%, and 34 new root procedures were necessary in 23%. Early mortality was 9.5% (n = 14). Female gender [odds ratio (OR) 6.16], coronary disease (OR 4.26) and lower creatinine clearance (OR 0.95) were independent predictors of early mortality. Follow-up was 98.6% complete [median 5.9 (interquartile range 1.7–10.9) years]. Survival was 74.1 ± 3.7%, 57.9 ± 5.1% and 43.8 ± 6.1% at 5, 10 and 14 years, respectively. Cox regression analysis revealed female gender [hazard ratio (HR) 1.73], diabetes (HR 1.73), coronary disease (HR 1.62) and peripheral vascular disease (HR 1.98) as independent determinants of late survival. CONCLUSIONS Despite many urgent situations and advanced New York Heart Association functional class at presentation, rAVS could be performed with acceptable early and late outcomes. Risk factors for survival were female gender, coronary disease and urgency. In this all-comers patient cohort needing rAVS, only a minority would eventually qualify for transcatheter valve-in-valve procedures.

scholarly journals TRANSCATHETER VALVE-IN-VALVE REPLACEMENT VERSUS REDO AORTIC VALVE SURGERY FOR BIOPROSTHETIC AORTIC VALVE DYSFUNCTION: A META-ANALYSIS

2018 ◽  
Vol 71 (11) ◽  
pp. A1411
Author(s):  
Saroj Neupane ◽  
Hemindermeet Singh ◽  
Johannes Lämmer ◽  
Hussein Othman ◽  
Hiroshi Yamasaki ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Meta Analysis ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Valve Dysfunction ◽  
Valve In Valve ◽  
Transcatheter Valve

Meta-Analysis of Transcatheter Valve-in-Valve Implantation Versus Redo Aortic Valve Surgery for Bioprosthetic Aortic Valve Dysfunction

2018 ◽  
Vol 121 (12) ◽  
pp. 1593-1600 ◽  
Author(s):  
Saroj Neupane ◽  
Hemindermeet Singh ◽  
Johannes Lämmer ◽  
Hussein Othman ◽  
Hiroshi Yamasaki ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Meta Analysis ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Valve Dysfunction ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

scholarly journals TCT-685 Results After Transcatheter Valve-in-Valve Implantation And Redo Aortic Valve Surgery For Failed Aortic Bioprostheses

2015 ◽  
Vol 66 (15) ◽  
pp. B280
Author(s):  
Magdalena Erlebach ◽  
Michael Wottke ◽  
Marcus-André Deutsch ◽  
Markus Krane ◽  
Nicolo Piazza ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Valve In Valve ◽  
Transcatheter Valve ◽  
Valve Implantation

Management of a Protruding Right Coronary Artery Stent during Aortic Valve Replacement for Aortic Stenosis

2012 ◽  
Vol 7 (3) ◽  
pp. 213-216 ◽  
Author(s):  
Nnamdi Nwaejike ◽  
Christopher Rozario ◽  
Franco Sogliani
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Medical Care ◽  
Valve Replacement ◽  
Coronary Intervention ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Percutaneous Coronary

We describe the successful management of a stent protruding from the right coronary ostium into the aortic root in the setting of aortic valve replacement for aortic stenosis. Due to advances in medical care more elderly patients present for aortic valve surgery after percutaneous coronary intervention. Therefore, with an aging population due to advances in medical care, more patients will present for aortic valve surgery after percutaneous coronary intervention. We suggest a degree of caution before valve deployment in transcatheter aortic valve intervention or during annular manipulation in patients undergoing traditional aortic valve replacement with coexisting patent proximal stents.

scholarly journals Reinterventions after freestyle stentless aortic valve replacement: an assessment of procedural risks

2019 ◽  
Vol 56 (6) ◽  
pp. 1117-1123 ◽  
Author(s):  
Adriaan W Schneider ◽  
Mark G Hazekamp ◽  
Michel I M Versteegh ◽  
Arend de Weger ◽  
Eduard R Holman ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Pacemaker Implantation ◽  
Implantation Rate ◽  
Careful Consideration ◽  
Early Mortality ◽  
Urgent Surgery ◽  
Structural Valve Deterioration ◽  
Transcatheter Valve

Abstract OBJECTIVES Repeat aortic valve interventions after previous stentless aortic valve replacement (AVR) are considered technically challenging with an increased perioperative risk, especially after full-root replacement. We analysed our experience with reinterventions after stentless AVR. METHODS A total of 75 patients with previous AVR using a Freestyle stentless bioprosthesis (31 subcoronary, 15 root-inclusion and 29 full-root replacement) underwent reintervention in our centre from 1993 until December 2018. Periprocedural data were retrospectively collected from the department database and follow-up data were prospectively collected. RESULTS Median age was 62 years (interquartile range 47–72 years). Indications for reintervention were structural valve deterioration (SVD) in 47, non-SVD in 13 and endocarditis in 15 patients. Urgent surgery was required in 24 (32%) patients. Reinterventions were surgical AVR in 16 (21%), root replacement in 51 (68%) and transcatheter AVR in 8 (11%) patients. Early mortality was 9.3% (n = 7), but decreased to zero in the past decade in 28 patients undergoing elective reoperation. Per indication, early mortality was 9% for SVD, 8% for non-SVD and 13% for endocarditis. Aortic root replacement had the lowest early mortality rate (6%), followed by surgical AVR (13%) and transcatheter AVR (25%, 2 patients with coronary artery obstruction). Pacemaker implantation rate was 7%. Overall survival rate at 10 years was 69% (95% confidence interval 53–81%). CONCLUSIONS Repeat aortic valve interventions after stentless AVR carry an increased, but acceptable, early mortality risk. Transcatheter valve-in-valve procedures after stentless AVR require careful consideration of prosthesis leaflet position to prevent obstruction of the coronary arteries.

scholarly journals Performance of EuroSCORE II in Predicting Early Mortality after Mitral, Aortic or Mitral & Aortic Valve Surgery Patients in National Heart Foundation Hospital and Research Institute

2019 ◽  
Vol 34 (1) ◽  
pp. 11-24
Author(s):  
Ahsan Uddin Mahmud ◽  
Md Faizus Sazzad ◽  
Mohammed Armane Wadud ◽  
Iftakher Raja Chowdhury ◽  
Mohammad Hafizur Rahman ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Early Mortality ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Additive Method ◽  
National Heart ◽  
Logistic Method ◽  
National Heart Foundation ◽  
Heart Foundation ◽  
Research Institute

Background: Preoperative risk assessment before cardiac surgery to predict mortality become literally important and practicing worldwide, whereas EuroSCORE II is most updated and popular. So we examined the hypothesis that Performance of EuroSCORE II in predicting early mortality after Mitral, Aortic or mitral & aortic valve surgery patients in National Heart Foundation Hospital and Research Institute. Objectives: To compare Euro SCORE II predicted early mortality and observed early mortality in a sample of patients of National Heart Foundation Hospital who underwent for Mitral, Aortic or Mitral & Aortic valve surgery. Methods: An observational prospective study was done in Department of cardiac surgery, National Heart Foundation Hospital and Research Institute who underwent for Mitral, Aortic or Mitral & Aortic valve surgery in the period of July 2016 to March 2018. Sample size was 356 and all inclusion criteria full filled. Patients were divided into 3 group (low, medium & high) depending on the score. Model discrimination and calibration were assessed additive and logistic EuroSCORE and EuroSCORE II. Results: The in hospital mortality of this series was 2.8% (10 out of 356) and the predicted mortality was 2.73% (95% CI 1.02-4.38) by the EuroSCORE II, 2.15% (95% CI 0.68- 3.72) by the additive method and 2.25% (95% CI 0.74-3.86) by the logistic EuroSCORE. The model’s discriminatory power also good and useful as indicated by an area under ROC curve of 0.779 in EuroSCORE II model, 0.675 in additive method and 0.696 in logistic method that means EuroSCORE II method can predict the outcome with 77% accuracy, additive method with 67% accuracy and the logistic method does that with 69% accuracy. Conclusion: EuroSCORE II was validated and performed well on National Heart Foundation patients and could be recommended as a simple risk stratification system to estimate the probability of early mortality in patients scheduled for valve surgery in Bangladesh. Bangladesh Heart Journal 2019; 34(1) : 11-24

scholarly journals Can the female gender influence risk factor identification for aortic valve surgery?

2014 ◽  
Vol 46 (5) ◽  
pp. 925-925 ◽  
Author(s):  
Kuk Hui Son ◽  
Chang Hu Choi ◽  
Kook Yang Park ◽  
Yang Bin Jeon
Keyword(s):  
Risk Factor ◽  
Aortic Valve ◽  
Female Gender ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Gender Influence
Sign in / Sign up

Export Citation Format

Share Document