Publications

Aortic Valve Replacement for Aortic Stenosis in Low-, Intermediate-, and High-Risk Patients: Preliminary Results From a Prospective Multicenter Registry  (2020)

Authors:
Onorati, F; Quintana, E; El-Dean, Z; Perrotti, A; Sponga, S; Ruggieri, Vg; Rinaldi, M; Milano, Ad; Santini, F; Chocron, S; Livi, U; Salizzoni, S; Loizzo, T; Salsano, A; Di Cesare, A; Faggian, G; Castella, M; Nicolini, F
Title:
Aortic Valve Replacement for Aortic Stenosis in Low-, Intermediate-, and High-Risk Patients: Preliminary Results From a Prospective Multicenter Registry
Year:
2020
Type of item:
Articolo in Rivista
Tipologia ANVUR:
Articolo su rivista
Language:
Inglese
Referee:
No
Name of journal:
Journal of Cardiothoracic and Vascular Anesthesia
ISSN of journal:
1053-0770
N° Volume:
34
Number or Folder:
8
Page numbers:
2091-2099
Keyword:
aortic valve replacement; transcatheter aortic valve implantation; aortic stenosis; surgical outcome
Short description of contents:
Objective: To evaluate current results of surgical aortic valve replacement (SAVR) +/- coronary artery bypass grafting surgery.Design: Independent, multicenter, prospective registry.Setting: Tertiary university hospitals.Participants: The study comprised 1,192 consecutive patients, stratified as low-, intermediate-, and high-risk according to EuroSCORE II (<4, 4-9, >9, respectively).Interventions: SAVR +/- coronary artery bypass grafting surgery.Measurements and Main Results: Thirty-day mortality and major morbidity, 2-year actuarial survival and freedom from stroke, and independent predictors of mortality in each risk category were assessed. These data were considered in light of published randomized controlled trials. Thirty-day mortality was 1.0%, 3.0% and 2.1% in the low-, intermediate-, and high-risk patients, with a 2-year actuarial survival of 98.6%, 93.8%, and 94.0%, respectively. Preoperative atrial fibrillation (odds ratio [OR] 8.3), minithoracotomy access (OR 5.8), postoperative dialysis (OR 3.4), type V acute myocardial infarction (OR 20.4), and moderate aortic regurgitation (OR 28.8) predicted 30-day mortality in the low-risk group. Preoperative dialysis (OR 18.3), critical state (OR 36.7), postoperative transfusions of plasma (OR 1.9 per unit transfused), and de-novo dialysis (OR 6.2) predicted 30-day mortality in the intermediate-risk group. Prior cardiac surgery (OR 18.1), postoperative extracorporeal membrane oxygenation (OR 9.8), and gastrointestinal complications (OR 17.2) predicted 30-day mortality in the high-risk group. Although baseline differences existed, low-risk patients demonstrated low 30-day mortality and 30-day to 12-month stroke in light of the PARTNER 3 and EVOLUT Low Risk trial results. Intermediate-risk patients demonstrated low 30-day to 2-year mortality, when the PARTNER 2 trial was considered, and low 30-day to 2-year stroke, when the PARTNER 2 and SURTAVI trials were considered. High-risk patients showed low 30-day to 2-year mortality in light of the results of the PARTNER 1 and CoreValve US trials.Conclusions: SAVR is still a safe and effective surgery for aortic stenosis regardless of risk category. (C) 2020 Elsevier Inc. All rights reserved.
Product ID:
116360
Handle IRIS:
11562/1025512
Last Modified:
November 17, 2022
Bibliographic citation:
Onorati, F; Quintana, E; El-Dean, Z; Perrotti, A; Sponga, S; Ruggieri, Vg; Rinaldi, M; Milano, Ad; Santini, F; Chocron, S; Livi, U; Salizzoni, S; Loizzo, T; Salsano, A; Di Cesare, A; Faggian, G; Castella, M; Nicolini, F, Aortic Valve Replacement for Aortic Stenosis in Low-, Intermediate-, and High-Risk Patients: Preliminary Results From a Prospective Multicenter Registry «Journal of Cardiothoracic and Vascular Anesthesia» , vol. 34 , n. 82020pp. 2091-2099

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