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Ann Thorac Surg 2000;70:1054-1059
© 2000 The Society of Thoracic Surgeons
a Duke University Medical Center, Durham, North Carolina, USA
b Heartport, Inc, Redwood City, California, USA
c New York University Medical Center, New York, New York, USA
d St. Francis Hospital, Roslyn, New York, USA
e Presbyterian Hospital, Dallas, Texas, USA
Address reprint requests to Dr Glower, Duke University Medical Center, Box 3851, Durham, NC 27710
e-mail: glowe001{at}mc.duke.edu
Presented at the Sixth Annual Cardiothoracic Techniques and Technologies Meeting 2000, Fort Lauderdale, FL, Jan 27–29, 2000.
Background. The aim of this study was to examine the predictors of outcome in patients undergoing isolated valve operation using port-access techniques.
Methods. Logistic regression analysis was performed in a prospective, multi-institutional registry of patients undergoing isolated aortic valve replacement (AVR, n = 252), mitral repair (MVP, n = 491), or mitral replacement (MVR, n = 568) using port-access techniques from 1997 to 1999.
Results. Endoaortic balloon occlusion was used in 2% (AVR), 93% (MVP), and 90% (MVR) of cases. Conversion to full sternotomy occurred in 3.8% of all cases. For all patients, early mortality was 50 of 1,311 (3.8%) and onset of new atrial fibrillation occurred in 140 of 1,311 (11%) patients. The determinants of 30-day mortality were redo, age, and MVR or AVR. The determinants of reoperation for bleeding were age, reoperation, and MVR. Age was a predictor for stroke, and age and low or medium volume center were predictors of new atrial fibrillation.
Conclusions. Excellent short-term results can be obtained using port-access techniques in isolated mitral or aortic valve operations. Patient outcome is not related to institutional case volume, and the primary determinants of outcome after port-access valve procedures are generally patient-related factors.
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