Patients undergoing isolated aortic valve replacement for aortic stenosis in 1991-2004 were older and had lighter valves with lower pressure gradients compared to those treated in 1961-1990.
Observational (n=1,849)
Yes
How have the clinical and pathological characteristics of patients undergoing isolated aortic valve replacement for aortic stenosis changed between 1961-1990 and 1991-2004?
Over time, patients undergoing aortic valve replacement for aortic stenosis have become older with less severe stenosis and lighter valves, although congenitally malformed valves remain the most common etiology.
BACKGROUND: Aortic valve replacement (AVR) for patients with aortic stenosis (AS) has now been available for 45 years. During this period, indications for the procedure have changed. METHODS AND RESULTS: Operatively excised stenotic aortic valves (with or without associated aortic regurgitation and without associated mitral valve disease) from 3 different medical centers (National Institutes of Health, Georgetown University Medical Center, and Baylor University Medical Center) were examined during 2 different time periods by the same physician to compare aortic valve structure, valve weight, age at operation, preoperative transvalvular peak pressure gradient, calculated aortic valve area, and whether simultaneous coronary artery bypass grafting (CABG) was performed. Compared with the first 3 decades (1961-1990) of AVR, patients having this operation during the fourth and fifth decades (1991-2004) had a lower frequency of congenitally malformed aortic valves, a higher frequency of tricuspid aortic valves, an older age, valves of lighter weight and lower transvalvular peak pressure gradients, and more often simultaneous CABG. CONCLUSIONS: Although patients having isolated AVR for AS in the present and last decade were older than in the first 3 decades of valve replacement surgery, congenitally malformed aortic valves continue to be more common than tricuspid aortic valves, but the degree of AS and therefore, valve weight was significantly lower than in the earlier decades.
Roberts et al. (Mon,) conducted a observational in Aortic Valve Stenosis (n=1,849). Aortic valve replacement during 1991-2004 vs. Aortic valve replacement during 1961-1990 was evaluated on Aortic valve structure, valve weight, age at operation, preoperative transvalvular peak pressure gradient, calculated aortic valve area, and simultaneous CABG. Patients undergoing isolated aortic valve replacement for aortic stenosis in 1991-2004 were older and had lighter valves with lower pressure gradients compared to those treated in 1961-1990.