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The Annals of Thoracic Surgery, Vol 57, 1140-1146, Copyright © 1994 by The Society of Thoracic Surgeons
GW He, TE Acuff, WH Ryan, MB Douthit, RT Bowman, YH He and MJ Mack
Contradictory results have been reported regarding risk factors for aortic
valve replacement (AVR). This study was designed to investigate
determinants of operative mortality for AVR with emphasis on concomitant
coronary artery bypass grafting (CABG) and old age. Between January 1986
and June 1992, 371 patients with a mean age of 61.99 +/- 0.76 years
underwent AVR. There were 256 men (69.0%) and 115 women (31.0%). Twenty-six
patients (7.0%) were 80 years old or older, and 97 (26.1%) were between 70
and 80 years old. Of these patients, 210 (56.6%) had isolated AVR, 142
(38.3%) had concomitant CABG, and 31 (8.4%) had concomitant mitral valve
operations. Twenty patients (5.4%) underwent emergency operation. There
were 33 operative deaths (8.9%). Univariate analysis and stepwise multiple
logistic regression analysis were used to determine the risk factors for
operative mortality. In the univariate analysis, 13 preoperative variables
(sex, age, history of congestive heart failure, myocardial infarction,
arrhythmia, functional class, class I/II versus III/IV, four variables
related to aortic valve pathology, ejection fraction, left ventricular
function) and 20 perioperative variables (emergency operation, individual
surgeon, myocardial protection by type and route of cardioplegia, type of
prosthesis, size of prosthesis, mean size by survival, small versus large
size, concomitant procedure, concomitant CABG (versus others or AVR alone),
concomitant mitral valve operation (versus others or AVR alone),
concomitant CABG and MV operation, aortic cross-clamp time, cardiopulmonary
bypass time, use and time of insertion of intraaortic balloon pump, low
cardiac output, postoperative complications) were examined.(ABSTRACT
TRUNCATED AT 250 WORDS)
ARTICLES
Aortic valve replacement: determinants of operative mortality
Cardiothoracic Surgery Associates of North Texas, Medical City Dallas Hospital 75230.
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