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Observed and relative survival after aortic valve replacement
P Kvidal1, R Bergström, L G Hörte
1Department of Cardiology, University Hospital, Uppsala, Sweden. per_kvidal@hotmail.com
Journal of the American College of Cardiology
|March 15, 2000
Summary
Old age does not increase excess mortality risk after aortic valve replacement (AVR). However, atrial fibrillation significantly reduces relative survival rates in patients undergoing AVR.
Area of Science:
- Cardiovascular Surgery
- Cardiac Valve Surgery
- Surgical Outcomes Research
Background:
- Aortic valve replacement (AVR) is increasingly performed in elderly patients.
- Survival analyses require age adjustment.
- Relative survival analysis offers insights into disease-specific mortality.
Purpose of the Study:
- To determine factors influencing optimal timing for aortic valve replacement (AVR).
- To evaluate observed and relative survival rates post-AVR.
- To identify risk factors affecting patient survival after AVR.
Main Methods:
- Survival analysis of 2,359 patients undergoing first AVR.
- Comparison of observed survival with expected survival in the general Swedish population.
- Estimation of relative and disease-specific survival rates.
Main Results:
- Early mortality (30-day) after AVR was 5.6%.
- 5, 10, and 15-year relative survival rates were 94.6%, 84.7%, and 74.9%, respectively.
- Advanced NYHA class, preoperative atrial fibrillation, and pure aortic regurgitation were independent risk factors for survival. Older patients had lower observed survival but excellent relative survival.
Conclusions:
- Advanced age is not a risk factor for excess mortality post-AVR.
- Atrial fibrillation significantly reduces relative survival after AVR.