Benchmarking Outcomes: Reoperation for Aortic Valve Patient Prosthesis Mismatch.

Benchmarking Outcomes: Reoperation for Aortic Valve Patient Prosthesis Mismatch. Ann Thorac Surg. 2020 Sep 24;: Authors: Keeling B, Beckerman Z, Wei J, Binongo J, Leshnower B, Chen E Abstract BACKGROUND: Surgical reoperations for symptomatic aortic valve patient prosthesis mismatch (PPM) are complex. The purpose of this research was to investigate the clinical and echocardiographic outcomes of patients who underwent reoperation for correction of symptomatic PPM following prior aortic valve replacement. METHODS: An institutional review identified 60 patients from 2004-2018 who underwent reoperative aortic valve replacement for PPM without structural valve degeneration. Univariate analyses were conducted to evaluate risk factors for perioperative mortality. RESULTS: Median patient age was 62.8(IQR 48.3-68.7) years, and mean body mass index was 29.2±6.6 kg/m2. 39 patients(66%) underwent a first-time reoperation, and 18(30.5%) underwent a second time reoperation. The median interval between initial operation to reoperation for the treatment of PPM was 89 months. 34 patients(56.7%) underwent aortic root replacement while the remainder(43.3%) underwent aortic valve replacement. Additional procedures included replacement of the ascending aorta with/without aortic arch in 26 patients (43.3%) and CABG 7(12%). Operative mortality and the rates of stroke and renal failure were 5.0%, 3.3% and 5.0%, respectively. Echo follow-up was available in 64.9%...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research

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This study evaluated national outcomes of MVS for PMR using the Society of Thoracic Surgeons (STS) National Database. METHODS: The study cohort was comprised of patients undergoing MVS for ischemic PMR between 2011 to 2018 in the STS registry. Concomitant procedures were included. The primary outcome was operative mortality. Secondary outcomes included STS major morbidities. Multivariable logistic regression was used for risk-adjustment using clinically important variables as well as those predictive in univariate analysis. RESULTS: 1,342 patients underwent MVS for PMR during the study period. The majority of the...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Abstract BACKGROUND: Microplegia has been studied during isolated coronary artery bypass grafting (CABG) and valve surgery, but not in more complex operations. Objectives of this study were to demonstrate safety and effectiveness of microplegia relative to Buckberg cardioplegia during these operations. METHODS: From 1/2012-1/2017, 242 patients underwent multi-component operations with simplified microplegia delivered via syringe pump and 10,512 with modified Buckberg cardioplegia. Operations included aortic root, arch, or ascending aorta replacement in 424 (94%), aortic valve surgery in 324 (72%), and concomi...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
CONCLUSION: Valve replacement in patients with hugely dilated left ventricle are safe operations with satisfactory outcomes even if combined with other procedures, especially with proper preoperative preparation, intraoperative preservation of posterior mitral leaflet, and meticulous postoperative follow up in the surgical ICU. PMID: 31895029 [PubMed - in process]
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
Authors: Wang TKM, Liao YB, Choi D, Harmos S, Haydcok D, Gerber I Abstract AIMS: A significant minority of patients undergoing mitral valve surgery (MVR) have indication for coronary artery bypass grafting (CABG). The risks of combination surgeries are not well appreciated and maybe more than additive. We compared the characteristics and outcomes of MVR+/-CABG performed at our centre. METHODS: Consecutive patients undergoing isolated MVR or with concurrent (MVR+)CABG at Auckland City Hospital during 2005-2012 were compared for baseline and operative characteristics and outcomes in univariable and multivariable ...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
ConclusionsConcomitant CABG at the time of AVR was performed without increasing early- or mid-term mortality. This absence of increased risk deserves consideration when choosing between different treatment strategies.
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Publication date: August 2018Source: The Annals of Thoracic Surgery, Volume 106, Issue 2Author(s): Bo Yang, Himanshu J. Patel, Elizabeth L. Norton, Christina Debenedictus, Linda Farhat, Xiaoting Wu, Kevin He, Whitney E. Hornsby, Donald S. Likosky, G. Michael DeebBackgroundLimited data are available regarding outcomes for stentless aortic valve reoperation. The reported reoperative mortality has been unacceptably high.MethodsBetween 1997 and 2017, a retrospective analysis was performed on 143 patients who underwent open aortic valve reoperations for failed stentless aortic valve bioprostheses. We evaluated both short-term a...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions Completely new STS ACSD risk models have been developed based on contemporary patient data; their performance is superior to that of previous STS ACSD models.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions New STS ACSD risk models have generally excellent calibration and discrimination and are well suited for risk adjustment of STS performance metrics.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions Aortic valve reoperation following stentless valve implantation can be performed with low operative mortality and favorable long-term survival.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract BACKGROUND: Limited data are available regarding outcomes for stentless aortic valve reoperation. The reported reoperative mortality has been unacceptably high. METHODS: Between 1997-2017, a retrospective analysis was performed on 143 patients that underwent open aortic valve reoperations for failed stentless aortic valve bioprostheses. We evaluated both short- and long-term outcomes on this cohort of patients. RESULTS: Bicuspid aortic valve was present in 107/143 (75%) of patients at the time of the initial Freestyle procedure and 84% (120/143) patients underwent a modified inclusion aortic roo...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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