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Improved early results after heart valve surgery over the last decade
Laila Hellgren1, Per Kvidal, Elisabeth Ståhle
1Department of Thoracic and Cardiovascular Surgery, Uppsala University Hospital, SE-751 85 Uppsala, Sweden. laila.hellgren@thorax.uas.lul.se
Objectives:
This study was undertaken to investigate time trends in early mortality, morbidity and clinical characteristics of patients undergoing heart valve surgery over the last decade.
Methods:
A regional, prospectively collected, study comprising all patients (2,327) undergoing valve surgery in a defined geographical area from January 1990 to December 1999 was conducted. Data were collected from 1,746 patients submitted to aortic valve replacement (AVR), 432 to mitral valve replacement (MVR), 78 to double valve replacement (DVR) and 71 to mitral valve repairs. Logistic regression was used to identify risk factors for early mortality. Time trends of early mortality, morbidity and clinical characteristics were analysed.
Results:
The total early mortality rate was 5.9%; for AVR it was 4.8%, MVR 9%, DVR 14% and mitral valve repair 1.4%. The risk factor profiles for early mortality were similar in all groups of valve interventions, with shock, age over 70 years and advanced NYHA class as the strongest risk factors. There was a decrease in early mortality over the period which remained after correction for risk factors. The proportion of patients over 70 years of age and of patients with diabetes increased, whereas other risk factors were not altered during the study period.
Conclusion:
It is confirmed that early risks for death after heart valve surgery have decreased. This improvement was consistent after adjustment for risk factors.