Hospital mortality after aortic valve replacement was 3%, with frequent ventricular ectopy (OR 9.78; 95% CI 1.91-50.2), diabetes (OR 3.88), and BMI >30 (OR 2.84) as key predictors.
Cohort (n=742)
What are the predictors of hospital mortality in patients with aortic stenosis undergoing surgical aortic valve replacement?
Hospital mortality after surgical aortic valve replacement is 3% and is significantly predicted by comorbidities like diabetes and obesity, as well as procedural complexity and preoperative ventricular ectopy.
Background: Understanding of the risk factors for the development of adverse outcomes after aortic valve replacement is necessary to develop timely preventive measures and to improve the results of surgical treatment. Methods: We analyzed patients with aortic stenosis (n = 742) who underwent surgical treatment in the period 2014−2020. The average age was 63 (57;69) years—men 58%, women 42%. Results: The hospital mortality rate was 3% (22 patients). The following statistically significant threshold values (cut-off points) were obtained in the ROC analysis: aortic cross-clamp time > 93 min AUC (CI) 0.676 (0.640−0.710), p = 0.010; cardiopulmonary bypass time > 144 min AUC (CI) 0.809 (0.778−0.837), p 2.39 AUC (CI) 0.647 (0.607−0.686), p = 0.014, end-systolic dimension index > 1.68 AUC (CI) 0.657 (0.617−0.695), p = 0.009. Statistically significant independent predictors of hospital mortality were identified: BMI > 30 kg/m2 (OR 2.84; CI 1.15−7.01), ischemic heart disease (OR 3.65; CI 1.01−13.2), diabetes (OR 3.88; CI 1.38−10.9), frequent ventricular ectopy before operation (OR 9.78; CI 1.91−50.2), mitral valve repair (OR 4.47; CI 1.76−11.3), tricuspid valve repair (OR 3.06; CI 1.09−8.58), 3 and more procedures (OR 4.44; CI 1.67−11.8). Conclusions: The hospital mortality rate was 3%. The main indicators associated with the risk of death were: diabetes, overweight (body mass index more than 30 kg/m2), frequent ventricular ectopy before surgery, hemoglobin level below 120 g/L, hematocrit level below 39%, longer cardiopulmonary bypass time and aortic cross-clamp time, additional mitral and tricuspid valve interventions.
Shvartz et al. (Wed,) conducted a cohort in Aortic stenosis (n=742). Aortic valve replacement was evaluated on Hospital mortality. Hospital mortality after aortic valve replacement was 3%, with frequent ventricular ectopy (OR 9.78; 95% CI 1.91-50.2), diabetes (OR 3.88), and BMI >30 (OR 2.84) as key predictors.
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