Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax

Mechanical aortic valve replacement (AVR) results have been published extensively in industrialized countries. Aim: To assess our immediate and late results in patients subjected to AVR. Patients and Methods: We retrospectively studied 194 patients subjected to isolated AVR between 1995 and 2003. Me...

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Autores principales:	Villavicencio T,Mauricio, Turner G,Eduardo, Naranjo T,Lorenzo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2005
Materias:	Aortic valve Endocarditis Heart valve diseases Rheumatic fever
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000005
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spelling	oai:scielo:S0034-988720050010000052005-12-05Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del TóraxVillavicencio T,MauricioTurner G,EduardoNaranjo T,Lorenzo Aortic valve Endocarditis Heart valve diseases Rheumatic fever Mechanical aortic valve replacement (AVR) results have been published extensively in industrialized countries. Aim: To assess our immediate and late results in patients subjected to AVR. Patients and Methods: We retrospectively studied 194 patients subjected to isolated AVR between 1995 and 2003. Mean age was 57 ± 13 years and 119 (61%) were male. One hundred thirty nine (73%) were in functional class III-IV, 20 (10%) had a previous cardiac operation and 25 (13%) were operated as an emergency. Surgical indication was stenosis in 110 (58%), regurgitation in 49 (26%) and stenosis/regurgitation in 31 (16%). Etiology was bicuspid valve 56 (29%), degenerative lesions 55 (28%), rheumatic valve disease 38 (20%) and endocarditis 27 (14%). Medtronic Hall was the most common prosthesis used in 157 patients (81%). Mean cardiopulmonary bypass time 97 ± 29 min and mean cross clamp time was 69 ± 21 min. Results: Operative mortality was 4.6% (3% in elective surgery, 16% in emergency surgery and 0% in reoperations). Follow-up was complete in 100% of cases, totalizing 636 patients-year. Survival was 91 ± 2%, 80 ± 4% and 73 ± 6%, at 1, 5 and 7 years, respectively. Multivariate risk analysis identified renal failure and endocarditis as predictors of early and late mortality. During follow up, the linear incidence rate for hemorrhage was 3.29% /patients-year, thromboembolism 2.04% patients-year and endocarditis 1.1% patients-year. Conclusions: AVR has low overall and elective mortality. Midterm survival is good but linear event rates related to anticoagulant treatment are higher than those previously published in industrialized countries. Renal failure and endocarditis were risk factors for early and late death (Rev Méd Chile 2005; 133: 1161-72)info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.133 n.10 20052005-10-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000005es10.4067/S0034-98872005001000005
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Aortic valve Endocarditis Heart valve diseases Rheumatic fever
spellingShingle	Aortic valve Endocarditis Heart valve diseases Rheumatic fever Villavicencio T,Mauricio Turner G,Eduardo Naranjo T,Lorenzo Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
description	Mechanical aortic valve replacement (AVR) results have been published extensively in industrialized countries. Aim: To assess our immediate and late results in patients subjected to AVR. Patients and Methods: We retrospectively studied 194 patients subjected to isolated AVR between 1995 and 2003. Mean age was 57 ± 13 years and 119 (61%) were male. One hundred thirty nine (73%) were in functional class III-IV, 20 (10%) had a previous cardiac operation and 25 (13%) were operated as an emergency. Surgical indication was stenosis in 110 (58%), regurgitation in 49 (26%) and stenosis/regurgitation in 31 (16%). Etiology was bicuspid valve 56 (29%), degenerative lesions 55 (28%), rheumatic valve disease 38 (20%) and endocarditis 27 (14%). Medtronic Hall was the most common prosthesis used in 157 patients (81%). Mean cardiopulmonary bypass time 97 ± 29 min and mean cross clamp time was 69 ± 21 min. Results: Operative mortality was 4.6% (3% in elective surgery, 16% in emergency surgery and 0% in reoperations). Follow-up was complete in 100% of cases, totalizing 636 patients-year. Survival was 91 ± 2%, 80 ± 4% and 73 ± 6%, at 1, 5 and 7 years, respectively. Multivariate risk analysis identified renal failure and endocarditis as predictors of early and late mortality. During follow up, the linear incidence rate for hemorrhage was 3.29% /patients-year, thromboembolism 2.04% patients-year and endocarditis 1.1% patients-year. Conclusions: AVR has low overall and elective mortality. Midterm survival is good but linear event rates related to anticoagulant treatment are higher than those previously published in industrialized countries. Renal failure and endocarditis were risk factors for early and late death (Rev Méd Chile 2005; 133: 1161-72)
author	Villavicencio T,Mauricio Turner G,Eduardo Naranjo T,Lorenzo
author_facet	Villavicencio T,Mauricio Turner G,Eduardo Naranjo T,Lorenzo
author_sort	Villavicencio T,Mauricio
title	Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
title_short	Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
title_full	Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
title_fullStr	Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
title_full_unstemmed	Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax
title_sort	resultados del reemplazo valvular aórtico con prótesis mecánica en el instituto nacional del tórax
publisher	Sociedad Médica de Santiago
publishDate	2005
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872005001000005
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Resultados del reemplazo valvular aórtico con prótesis mecánica en el Instituto Nacional del Tórax

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