[Aortic valve replacement: the experiences of 1026 cases]

Area of Science:

• Cardiovascular Surgery
• Cardiac Valve Disease
• Surgical Outcomes Research

Context:

• Aortic valve replacement (AVR) is a critical procedure for managing severe aortic valve disease.
• Understanding trends in pathogenic causes and long-term prognosis is essential for optimizing patient care.
• This study retrospectively analyzed data from 1026 patients undergoing AVR between 1980 and 2006.

Purpose:

• To investigate the evolving etiologies of aortic valve pathology leading to AVR.
• To assess the short-term and long-term outcomes, including mortality and morbidity, following AVR.
• To identify key risk factors influencing operative and late mortality after AVR.

Summary:

• Postoperative mortality within 30 days was 4.3%, with heart failure, multi-organ failure, and endocarditis as primary causes.
• Major risk factors for operative death included low left ventricle ejection fraction (<0.4), endocarditis, valve regurgitation, and emergency surgery.
• Late mortality was 3.4% (0.54% per patient-year), mainly due to heart failure, endocarditis, and arrhythmias. Reoperation rates were 1.4% (0.22% per patient-year).

Impact:

• The study observed a decline in rheumatic heart disease and a rise in degenerative valve disease as indications for AVR.
• Findings highlight the importance of avoiding prosthesis-patient mismatch and implementing effective postoperative management.
• Preventing endocarditis and optimizing surgical techniques are crucial for improving the long-term prognosis of patients undergoing AVR.