A long-term follow-up study of valve replacements
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Long-term valve replacement surgery outcomes show a 68.7% survival rate at 12 years. Social return rates improved, reaching 76.4% in the last five years for these cardiac patients.
Area of Science:
- Cardiovascular Surgery
- Clinical Outcomes Research
Background:
- Cardiac valve replacement is a critical intervention for severe valvular heart disease.
- Understanding long-term outcomes and social reintegration is essential for patient management.
Purpose of the Study:
- To evaluate the long-term results of valve replacement operations.
- To analyze the rates of social return following cardiac valve surgery.
Main Methods:
- Retrospective study of 591 patients undergoing valve replacement, with follow-up of one year or more.
- Social return assessment via questionnaire in 523 patients (86.1% response rate).
Main Results:
- Early mortality was 13.7% (81 patients), and late mortality was 6.9% (41 patients).
- Common causes of late death included left atrial thrombus, heart failure, and artificial valve failure.
- The 12-year survival rate was 68.7%.
- Overall social return rate was 64.8%, varying by valve type (mitral 74.8%, aortic 54.3%, multivalvular 51.5%).
- Social return rates improved to 76.4% in the most recent five-year period.
Conclusions:
- Valve replacement offers a significant survival benefit, with a 12-year survival rate of 68.7%.
- Social return is achievable, particularly after mitral valve replacement, and has shown recent improvement.
- Addressing complications like thrombus formation and valve failure is crucial for enhancing long-term patient outcomes.
Abstract:
We have studied the long-term results of valve replacement operations in 591 patients, one year or more after surgery, and also analyzed rates of social return in 523 patients (response rate, 86.1 per cent) by questionnaire. Of the 591 patients, 81 patients suffered early death (mortality rate, 13.7 per cent) and 41 patients late death (mortality rate, 6.9 per cent). The causes of the latter were left atrial thrombus (18 cases), heart failure (10 cases), artificial valve failure (five cases), renal failure (two cases) and hepatic insufficiency, infection and accident (one case each). Second replacement was performed in 18 patients (3.0 per cent), 49 months on average from the first operation. The survival rate at the 12th postoperative year was 68.7 per cent. The overall rate of social return after valve replacement was 64.8 per cent, including 74.8 per cent for mitral valve replacement, 54.3 per cent for aortic and 51.5 for multivalvular. The rate of social return has been improved to 76.4 per cent in the last five years.