AI Article Synopsis

  • The study aimed to evaluate long-term survival rates following first-time aortic valve replacement surgery, considering valve types (bicuspid vs. tricuspid) and whether combined surgery with coronary artery bypass was performed.
  • A total of 5,086 patients from three Swedish hospitals were analyzed, with a focus on long-term survival rates after excluding early mortality within the first 30 days.
  • Results showed that patients with bicuspid valves had better long-term survival profiles compared to the general population, and the addition of coronary bypass surgery did not negatively impact survival outcomes.

Article Abstract

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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043765PMC
http://dx.doi.org/10.1093/ejcts/ezaa348DOI Listing

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