PMID- 16845846
OWN - NLM
STAT- MEDLINE
DCOM- 20060801
LR  - 20060718
IS  - 0743-6661 (Print)
IS  - 0743-6661 (Linking)
VI  - 38
IP  - 2
DP  - 2006
TI  - Aortic valve replacement and long-term prognosis.
PG  - 126-35
AB  - OBJECTIVE: We assessed the long-term risk of mortality associated with mechanical 
      and biological aortic valve replacement (AVR). METHODS: We reviewed articles 
      published during the last decade, with emphasis on large series reporting 
      mortality data and follow up of 5 years or longer. The latest editions of 
      textbooks on cardiology and cardiac surgery were also reviewed. We used mortality 
      analysis methodology, comparing the observed mortality in these series to the 
      expected mortality calculated from country specific life tables, to calculate the 
      risk of mortality expressed as the mortality ratio (MR), values above 100% 
      traducing the excess risk of mortality compared to the general population. 
      RESULTS: After AVR, the MR varied from 120% to 350% for mechanical valve 
      prostheses, and from 100% to 300 for bioprosthetic valves according to age at 
      surgery. MR above 400% was associated with an AVR before the age of 50 years. No 
      significant difference in the MR over age 50 years was found between mechanical 
      and biological AVR. Independent prognostic factors after AVR are age at surgery, 
      New York Heart Association (NYHA) functional class at time of surgery, left 
      ventricular ejection fraction (LVEF), atrial fibrillation, and type and severity 
      of valvular lesion. CONCLUSION: No difference was found for excess mortality 
      between mechanical and biological AVR. Under the age of 50 years, higher 
      mortality was associated with both mechanical and bioprosthetic AVR.
FAU - Naslafkih, Abdelouahed
AU  - Naslafkih A
AD  - Universite de Montreal, Insurance Medicine Program, CP 6128 Succ, Centre-ville, 
      Montreal, QC, Canada H3C 3J7.
FAU - Francois, Sestier
AU  - Francois S
FAU - Fix, Jean-Marc
AU  - Fix JM
FAU - Khoury, Abdelnour
AU  - Khoury A
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - J Insur Med
JT  - Journal of insurance medicine (New York, N.Y.)
JID - 8401468
MH  - Aged
MH  - Aortic Valve/physiopathology/*surgery
MH  - Female
MH  - Heart Valve Prosthesis Implantation/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - *Risk Adjustment
MH  - Survivors
MH  - United States/epidemiology
RF  - 45
EDAT- 2006/07/19 09:00
MHDA- 2006/08/02 09:00
CRDT- 2006/07/19 09:00
PHST- 2006/07/19 09:00 [pubmed]
PHST- 2006/08/02 09:00 [medline]
PHST- 2006/07/19 09:00 [entrez]
PST - ppublish
SO  - J Insur Med. 2006;38(2):126-35.