Long-term valve-related complications following aortic valve prosthesis implantation occurred at 4.2/100 patient-years, with incidence significantly increased by high preoperative cardiothoracic index.
Cohort (n=139)
Long-term complications following implantation of aortic valve prosthesis were assessed in 139 patients who had survived greater than 30 postoperative days (maximum follow-up 17 years). Most of the prostheses were Starr-Edwards valves (38 silastic ball, SESB, and 96 cloth-covered, SECC). All patients received maintenance coumarin. The rate of thromboembolic complications was 1.6/100 patient-years, without difference between SESB and SECC valves although there were no episodes with SESB from 6 years postoperatively. The overall rate of valve-related complications (VRC)--thromboembolism, hemorrhage, endocarditis, re-replacement, etc.--was 4.2/100 patient-years. High preoperative cardiothoracic index (CTI) significantly increased the incidence of VRC. Preoperative NYHA class III-IV and high CTI similarly influenced the rate of serious VRC (= VRC excluding extremity emboli, epistaxis and subcutaneous bleeding). The valve-and-heart-related morbidity (= VRC including myocardial infarction and pacemaker requirement) was also influenced by preoperative CTI. The long-term complications thus were not exclusively attributable to the prosthesis, but also to preoperative patient-related data.
Ole Lund (Fri,) conducted a cohort in Aortic valve prosthesis (n=139). Aortic valve prosthesis (Starr-Edwards silastic ball or cloth-covered) was evaluated on Overall rate of valve-related complications (VRC). Long-term valve-related complications following aortic valve prosthesis implantation occurred at 4.2/100 patient-years, with incidence significantly increased by high preoperative cardiothoracic index.