PMID- 25476461
OWN - NLM
STAT- MEDLINE
DCOM- 20151117
LR  - 20150214
IS  - 1569-9285 (Electronic)
IS  - 1569-9285 (Linking)
VI  - 20
IP  - 3
DP  - 2015 Mar
TI  - Triple valve replacement for rheumatic heart disease: short- and mid-term 
      survival in modern era.
PG  - 359-64
LID - 10.1093/icvts/ivu400 [doi]
AB  - OBJECTIVES: Triple valve replacement (TVR) is still deemed a complex and 
      challenging choice for rheumatic heart disease (RHD) and carries significant 
      mortality and morbidity. We report the short- and mid-term results after TVR in 
      the last decade. METHODS: In a historical cohort, ninety consecutive patients, at 
      a mean age of 47 +/- 12 years underwent TVR between 2003 and 2013 for RHD. Most of 
      the patients were in the New York Heart Association (NYHA) functional class II or 
      III. Univariate and multivariate analyses were performed to identify the 
      predictors of overall and event-free survival. RESULTS: The 30-day hospital 
      mortality rate was 6% (n = 5). One-year and 4-year overall survival (cardiac 
      survival) rates were 91.7 and 89.5%, respectively. One-year and 4-year rates of 
      freedom from cardiac events (e.g. cardiac death, cardiac rehospitalization, 
      cardiac reoperation, cerebrovascular events, anticoagulation-related major 
      haemorrhage and significant valvular malfunction) were 83.5 and 69.5%, 
      respectively. Age, diabetes and pump time were the independent predictors of 
      overall survival, and diabetes and hypertension were the independent predictors 
      of event-free survival. One-year and 4-year freedom rates from 
      anticoagulation-related major haemorrhage were 96.6 and 90.7%, respectively. The 
      1-year and 4-year rates of freedom from a composite of valvular thrombosis, major 
      bleeding events and thromboemboli were 94.1 and 88.5%, respectively. One-year and 
      4-year freedom rates from cardiac rehospitalization were 94.0 and 88.0%, 
      respectively. One-year and 4-year rates of freedom from cardiac reoperation were 
      98.8 and 93.9%, respectively. One-year and 4-year rates of freedom from 
      significant prosthetic valve malfunction (e.g. structural valve deterioration, 
      valve thrombosis and paravalvular leakage) were 96.6 and 90.7%, respectively. The 
      1-year and 4-year rates of freedom from major adverse valve-related events were 
      86.3 and 78.5%, respectively. CONCLUSIONS: TVR for RHD appears to confer 
      satisfactory short- and mid-term results with excellent symptomatic improvement. 
      The overall mortality following TVR may be improved by early surgical treatment 
      before the NYHA functional class IV.
CI  - (c) The Author 2014. Published by Oxford University Press on behalf of the European 
      Association for Cardio-Thoracic Surgery. All rights reserved.
FAU - Davarpasand, Tahereh
AU  - Davarpasand T
AD  - Department of Cardiology, Tehran Heart Center, Tehran University of Medical 
      Sciences, Tehran, Iran.
FAU - Hosseinsabet, Ali
AU  - Hosseinsabet A
AD  - Department of Cardiology, Tehran Heart Center, Tehran University of Medical 
      Sciences, Tehran, Iran ali_hosseinsabet@yahoo.com.
LA  - eng
PT  - Journal Article
DEP - 20141204
PL  - England
TA  - Interact Cardiovasc Thorac Surg
JT  - Interactive cardiovascular and thoracic surgery
JID - 101158399
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Valve Diseases/etiology/mortality/*surgery
MH  - Heart Valve Prosthesis Implantation/*methods
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Iran/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Rheumatic Heart Disease/complications/mortality/*surgery
MH  - Survival Rate/trends
MH  - Young Adult
OTO - NOTNLM
OT  - Rheumatic heart disease
OT  - Survival
OT  - Triple valve replacement
EDAT- 2014/12/06 06:00
MHDA- 2015/11/18 06:00
CRDT- 2014/12/06 06:00
PHST- 2014/12/06 06:00 [entrez]
PHST- 2014/12/06 06:00 [pubmed]
PHST- 2015/11/18 06:00 [medline]
AID - ivu400 [pii]
AID - 10.1093/icvts/ivu400 [doi]
PST - ppublish
SO  - Interact Cardiovasc Thorac Surg. 2015 Mar;20(3):359-64. doi: 
      10.1093/icvts/ivu400. Epub 2014 Dec 4.