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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Coronary revascularization after surgical aortic valve replacement

Mevlüt Çelik1, Andras P Durko1, Stuart J Head1,2

  • 1Department of Cardiothoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.

JTCVS Open
|August 25, 2022
PubMed

Insights

Coronary revascularization after surgical aortic valve replacement (SAVR) occurred in 6.9% of patients over 20 years. Previous revascularization significantly increased this risk, a finding relevant for transcatheter aortic valve replacement decisions.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Interventional Cardiology

Background:

  • The necessity of coronary revascularization post-aortic valve intervention remains unclear.
  • Data on revascularization rates after surgical aortic valve replacement (SAVR) are crucial for treatment and prosthesis selection.
  • This study analyzes coronary revascularization incidence and characteristics following SAVR.

Purpose of the Study:

  • To determine the incidence of coronary revascularization after SAVR.
  • To identify predictors of coronary revascularization after SAVR.
  • To characterize revascularization procedures performed after SAVR.

Main Methods:

  • Analysis of 420 patients who underwent isolated SAVR between 1987 and 2015.
  • Assessment of cumulative incidence using a competing risk approach.
  • Identification of predictors for revascularization during follow-up.

Main Results:

  • The 20-year cumulative incidence of coronary revascularization after SAVR was 6.9%.
  • The linearized rate of revascularization was 6.2 per 1000 patient-years.
  • Prior revascularization before SAVR was an independent predictor of subsequent revascularization (HR 6.6, P < .001).

Conclusions:

  • Coronary revascularization is infrequent but occurs in 6.9% of patients up to 20 years post-SAVR.
  • Patients with prior revascularization are at higher risk.
  • Findings may inform decisions for transcatheter aortic valve replacement patients.
Abstract

Keywords:
AS, aortic valve stenosisCABG, coronary artery bypass graftingCAD, coronary artery diseaseLVEF, left ventricular ejection fractionPCI, percutaneous coronary interventionSAVR, surgical aortic valve replacementTAVR, transcatheter aortic valve replacemenaortic stenosisaortic valve replacementcoronary artery bypass graftingpercutaneous coronary interventiontranscatheter

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