Clinical Outcomes of Mitral Valve Reoperations in the United States: An Analysis of the Society of Thoracic Surgeons National Database.

MedStar author(s):
Citation: Annals of Thoracic Surgery. 2018 Oct 23PMID: 30365952Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2018Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:
  • 0003-4975
Name of journal: The Annals of thoracic surgeryAbstract: BACKGROUND: This study evaluated outcomes of reoperative mitral valve surgery (MVS) in the United States.CONCLUSIONS: Despite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.Copyright (c) 2018. Published by Elsevier Inc.METHODS: Adults undergoing isolated MVS with prior open-heart surgery in the Society of Thoracic Surgeons (STS) National Database between July 2011 and September 2016 were included. Urgent or emergent cases as well as all indications and etiologies for MVS were included. Primary outcomes were operative mortality and morbidity. Multivariable models were used for risk-adjustment incorporating variables from the STS Valve Risk Model as well as type of prior operation and reoperative approach.RESULTS: 17,195 patients underwent isolated reoperative MVS at 962 centers. The STS predicted risk of mortality (STS-PROM) was 8.0%, with 20% having an STS-PROM of >10%. Prior cardiac operations included previous mitral valve surgery (61%), coronary artery bypass (39%), aortic valve surgery (18%), and tricuspid valve surgery (6%). Operative mortality for the overall study cohort was 6.6% and postoperative stroke occurred in 2.4%. Observed-to-expected mortality for the overall cohort was 0.82. The strongest independent predictors of operative mortality included salvage operation, preoperative dialysis dependence, congestive heart failure, recent myocardial infarction, and active endocarditis. Prior aortic valve replacement was associated with increased mortality risk whereas prior mitral valve surgery reduced mortality risk. Surgical approach did not impact mortality. For elective, non-endocarditis cases with prior mitral surgery, the operative mortality was 3.4%.All authors: Acker MA, Ailawadi G, Badhwar V, Gleason TG, Kilic A, Kilic A, Sultan I, Thibault D, Thourani V, Vemulapalli SFiscal year: FY2019Digital Object Identifier: Date added to catalog: 2018-11-09
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30365952 Available 30365952

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

BACKGROUND: This study evaluated outcomes of reoperative mitral valve surgery (MVS) in the United States.

CONCLUSIONS: Despite a high-risk patient profile, surgical outcomes of reoperative MVS were acceptable, particularly in elective cases with prior mitral valve surgery and without endocarditis.

Copyright (c) 2018. Published by Elsevier Inc.

METHODS: Adults undergoing isolated MVS with prior open-heart surgery in the Society of Thoracic Surgeons (STS) National Database between July 2011 and September 2016 were included. Urgent or emergent cases as well as all indications and etiologies for MVS were included. Primary outcomes were operative mortality and morbidity. Multivariable models were used for risk-adjustment incorporating variables from the STS Valve Risk Model as well as type of prior operation and reoperative approach.

RESULTS: 17,195 patients underwent isolated reoperative MVS at 962 centers. The STS predicted risk of mortality (STS-PROM) was 8.0%, with 20% having an STS-PROM of >10%. Prior cardiac operations included previous mitral valve surgery (61%), coronary artery bypass (39%), aortic valve surgery (18%), and tricuspid valve surgery (6%). Operative mortality for the overall study cohort was 6.6% and postoperative stroke occurred in 2.4%. Observed-to-expected mortality for the overall cohort was 0.82. The strongest independent predictors of operative mortality included salvage operation, preoperative dialysis dependence, congestive heart failure, recent myocardial infarction, and active endocarditis. Prior aortic valve replacement was associated with increased mortality risk whereas prior mitral valve surgery reduced mortality risk. Surgical approach did not impact mortality. For elective, non-endocarditis cases with prior mitral surgery, the operative mortality was 3.4%.

English

Powered by Koha