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Long-term results after aortic valve replacement for bicuspid or tricuspid valve morphology in a Swedish population
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin. Heart Centre, Umeå University, Umeå, Sweden..
Clinic of Medicine, St. Olavs University Hospital, Trondheim, Norway.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Avdelningen för medicin.
Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Trondheim, Norway; Department of Immunology and Transfusion Medicine, St. Olavs University Hospital, Trondheim, Norway.
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2021 (Engelska)Ingår i: European Journal of Cardio-Thoracic Surgery, ISSN 1010-7940, E-ISSN 1873-734X, Vol. 59, nr 3, s. 570-576Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: Our goal was to study long-term observed and relative survival after first-time aortic valve replacement surgery with or without concomitant coronary artery bypass surgery with reference to valve morphology (i.e. bicuspid vs tricuspid).

METHODS: Consecutive patients (n = 5086) from 3 Swedish hospitals, operated on between 1 January 2005 and 31 December 2016, were included. The 30-day mortality (n = 116, 2.3%) was excluded from the analysis of long-term observed and relative survival (n = 4970). Observed survival was analysed using Cox regression. Relative survival was calculated as the ratio between observed and expected survival based on data from the general Swedish population, matched for age, sex and calendar year. Risk factors for death were explored using multivariable analysis.

RESULTS: During the follow-up (median 4.7 years) period, 1157 (23%) patients died. Observed survival excluding 30-day mortality was 96.6%, 82.7% and 57.6% after 1, 5 and 10 years. Compared with the general Swedish population, the relative 1-, 5- and 10-year survival rates were 99.0%, 97.5% and 89.0%. Bicuspid morphology was independently associated with higher observed and relative long-term survival. Renal dysfunction, diabetes, chronic obstructive pulmonary disease, heart failure, smoking and atrial fibrillation were associated with higher long-term mortality. Combined surgery was not associated with higher observed or relative mortality.

CONCLUSIONS: Patients with a bicuspid morphology had better prognosis, matching that of the general population. With increased age, long-term relative survival compared favourably with survival in the general Swedish population. Adding coronary artery bypass surgery to an aortic valve replacement procedure did not affect long-term outcome.

Ort, förlag, år, upplaga, sidor
Oxford University Press, 2021. Vol. 59, nr 3, s. 570-576
Nyckelord [en]
Aortic stenosis, Aortic valve replacement, Bicuspid valve, Observed survival, Relative survival
Nationell ämneskategori
Kirurgi Kardiologi
Identifikatorer
URN: urn:nbn:se:umu:diva-182758DOI: 10.1093/ejcts/ezaa348ISI: 000646254500007PubMedID: 33179723Scopus ID: 2-s2.0-85104275889OAI: oai:DiVA.org:umu-182758DiVA, id: diva2:1556649
Tillgänglig från: 2021-05-24 Skapad: 2021-05-24 Senast uppdaterad: 2023-09-05Bibliografiskt granskad

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Holmgren, AndersNäslund, UlfWahba, Alexander

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