Aortic valve replacement in bioprosthetic failure:Insights from the society of thoracic surgeons national database.
Title
Aortic valve replacement in bioprosthetic failure:Insights from the society of thoracic surgeons national database.
Creator
Kalra A; Raza S; Hussain M; Shorbaji K; Delozier S; Deo VS; Khera S; Kleiman NS; Reardon MJ; Kolte D; Gupta T; Mustafa RR; Bhatt DL; Sabik JF 3rd
Publisher
The Annals of thoracic surgery
Date
2019
2019-09-23
Description
BACKGROUND: To determine the current nationwide trends and outcomes of reoperative surgical aortic valve replacement (SAVR) performed for degenerated bioprosthesis. METHODS: The study was conducted using data from the Society of Thoracic Surgeons (STS) Adult Cardiac Surgery Database. All patients who had isolated reoperative SAVR for a degenerated aortic bioprosthesis between January 2012 and December 2016 were included. Patients who had other concomitant cardiac surgery procedures or active endocarditis were excluded. Trend analyses were conducted to track changes during this time period. RESULTS: The number of patients undergoing SAVR for bioprosthetic failure increased substantially between 2012 and 2014 (782 in 2012 to 844 in 2013 and 900 in 2014; relative change = +7.25%); this trend reversed significantly between 2015 and 2016 (decreased to 873 in 2015 and 840 in 2016; relative change = -3.4%, P= 0.005). Patients were older in 2012-2014 (65.80 ± 13.52 years) compared with 2015-2016 (64.45 ± 12.91 years; P= 0.001). Mean STS-predicted mortality risk score decreased from 4.55% in 2012-2014 to 4.25% in 2015-2016 (P = 0.001). There was no difference in post-operative stroke (1.80% vs. 1.80%, P= 0.87), renal failure requiring dialysis (2.7% vs. 2.8%, P= 0.69), or operative mortality (3.5% vs. 4.0%, P= 0.36) after reoperative SAVR in 2012-2014 and 2015-2016, respectively. CONCLUSIONS: The number of patients undergoing SAVR for degenerated bioprosthesis is decreasing in U.S, particularly among older and high-risk patients. These trends may reflect the adoption of valve-in-valve transcatheter aortic valve replacement for degenerated bioprosthesis after its FDA approval in 2015.
Rights
Copyright © 2019. Published by Elsevier Inc.
Format
journalArticle
URL Address
Search for Full-text
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ISSN
1552-6259 0003-4975
NEOMED College
NEOMED College of Medicine
NEOMED Department
Department of Internal Medicine
Update Year & Number
June2020SubmittedList
Affiliated Hospital
Cleveland Clinic Akron General Hospital
Citation
Kalra A; Raza S; Hussain M; Shorbaji K; Delozier S; Deo VS; Khera S; Kleiman NS; Reardon MJ; Kolte D; Gupta T; Mustafa RR; Bhatt DL; Sabik JF 3rd, “Aortic valve replacement in bioprosthetic failure:Insights from the society of thoracic surgeons national database.,” NEOMED Bibliography Database, accessed April 24, 2024, https://neomed.omeka.net/items/show/11174.