Key result
Current preoperative heart failure caused a 3-fold increase in operative mortality and an 86% increase in late mortality up to 10 years after aortic valve replacement.
Why the study?
Does preoperative heart failure increase operative and late mortality in patients undergoing aortic valve replacement?
Cohort (n=849)
Does preoperative heart failure increase operative and late mortality in patients undergoing aortic valve replacement?
Effect estimate: 3-fold increase in operative mortality and 86% increase in late mortality for current heart failure
Preoperative heart failure significantly increases both operative and late mortality up to 10 years after aortic valve replacement, supporting early surgical intervention before frank heart failure develops.
Preoperative heart failure flags high-risk AVR patients; leaves open whether earlier intervention improves outcomes.
Congestive heart failure complicating aortic valve disease has been reported to increase the operative mortality associated with aortic valve replacement. To determine whether this adverse effect remains late after aortic valve replacement, we analyzed prospectively collected and survival data of 849 patients who underwent aortic valve replacement between 1999 and 2008. There were 243 (29%) cases of heart failure preoperatively (138 current and 105 prior). Both operative and late mortality rates (up to 10 years) were significantly higher in heart failure patients. Current congestive heart failure caused a 3-fold increase in operative mortality and an 86% increase in late mortality, whereas previous history of heart failure caused a doubling of late mortality. Preoperative heart failure still compromises early and late survival after aortic valve replacement. Surgery should be considered early in patients with aortic valve disease and deferred, when possible, in those with frank heart failure.
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Ngaage et al. (2010) conducted a cohort in Aortic valve disease (n=849). Preoperative heart failure vs. No preoperative heart failure was evaluated on Operative and late mortality (3-fold increase in operative mortality and 86% increase in late mortality for current heart failure). Current preoperative heart failure caused a 3-fold increase in operative mortality and an 86% increase in late mortality up to 10 years after aortic valve replacement.
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