PMID- 28674629
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2053-3624 (Print)
IS  - 2053-3624 (Electronic)
IS  - 2053-3624 (Linking)
VI  - 4
IP  - 1
DP  - 2017
TI  - Morbidity outcomes after surgical aortic valve replacement.
PG  - e000588
LID - 10.1136/openhrt-2017-000588 [doi]
LID - e000588
AB  - OBJECTIVE: In patients with mild to moderate operative risk, surgical aortic 
      valve replacement (SAVR) is still the preferred treatment for patients with 
      severe symptomatic aortic stenosis (AS). Aiming to broaden the knowledge of 
      postsurgical outcomes, this study reports a broad set of morbidity outcomes 
      following surgical intervention. METHODS: Our cohort comprised 442 patients 
      referred for severe AS; 351 had undergone SAVR, with the remainder (91) not 
      operated on. All patients were evaluated using the 6-minute walk test (6MWT), 
      were assigned a New York Heart Association class (NYHA) and Canadian 
      Cardiovascular Society class (CCS), with additional scores for health-related 
      quality of life (HRQoL), cognitive function (Mini-Mental State Examination 
      (MMSE)) and myocardial remodelling (at inclusion and at 1-year follow-up). 
      Adverse events and mortality were recorded. RESULTS: Three-year survival after 
      SAVR was 90.0%. SAVR was associated with an improved NYHA class, CCS score and 
      HRQoL, and provoked reverse ventricular remodelling. The 6MWT decreased, while 
      the risks of major adverse cardiovascular events (death, non-fatal 
      stroke/transient ischaemic attack or myocardial infarction) and all-cause 
      hospitalisation (incidence rate per 100 patient-years) were 13.5 and 62.4, 
      respectively. The proportion of cognitive disability measured by MMSE increased 
      after SAVR from 3.2% to 8.8% (p=0.005). Proportion of patients living 
      independently at home, having attained NYHA class I, was met by 49.1% at 1 year. 
      Unoperated individuals had a poor prognosis in terms of any outcome. CONCLUSION: 
      This study provides knowledge of outcomes beyond what is known about the 
      mortality benefit after SAVR to provide insight into the morbidity burden of 
      modern-day SAVR.
FAU - Auensen, Andreas
AU  - Auensen A
AD  - Department of Cardiology, Faculty of Medicine, Oslo University Hospital 
      Rikshospitalet, Oslo, Norway.
FAU - Hussain, Amjad Iqbal
AU  - Hussain AI
AD  - Department of Cardiology, Akershus University Hospital, Lorenskog, Norway.
FAU - Bendz, Bjorn
AU  - Bendz B
AD  - Department of Cardiology, Faculty of Medicine, Oslo University Hospital 
      Rikshospitalet, Oslo, Norway.
FAU - Aaberge, Lars
AU  - Aaberge L
AD  - Department of Cardiology, Faculty of Medicine, Oslo University Hospital 
      Rikshospitalet, Oslo, Norway.
FAU - Falk, Ragnhild Sorum
AU  - Falk RS
AD  - Oslo Center for Biostatistics and Epidemiology, Oslo, Norway.
FAU - Walle-Hansen, Marte Meyer
AU  - Walle-Hansen MM
AD  - Faculty of Medicine, University of Oslo, Oslo, Norway.
FAU - Bye, Jorun
AU  - Bye J
AD  - Faculty of Medicine, University of Oslo, Oslo, Norway.
FAU - Andreassen, Johanna
AU  - Andreassen J
AD  - Department of Cardiology, Faculty of Medicine, Oslo University Hospital 
      Rikshospitalet, Oslo, Norway.
FAU - Beitnes, Jan Otto
AU  - Beitnes JO
AD  - Department of Cardiology, Oslo University Hospital, Oslo, Norway.
FAU - Rein, Kjell Arne
AU  - Rein KA
AD  - Department of Cardiothoracic Surgery, Oslo University Hospital Rikshospitalet, 
      Oslo, Norway.
FAU - Pettersen, Kjell Ingar
AU  - Pettersen KI
AD  - Department of Cardiology, Faculty of Medicine, Oslo University Hospital 
      Rikshospitalet, Oslo, Norway.
FAU - Gullestad, Lars
AU  - Gullestad L
AD  - Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
LA  - eng
PT  - Journal Article
DEP - 20170413
PL  - England
TA  - Open Heart
JT  - Open heart
JID - 101631219
PMC - PMC5471875
OTO - NOTNLM
OT  - Aortic valvne disease
OT  - Quality of care and outcomes
OT  - Surgery -valve
COIS- Competing interests: None declared.
EDAT- 2017/07/05 06:00
MHDA- 2017/07/05 06:01
PMCR- 2017/04/13
CRDT- 2017/07/05 06:00
PHST- 2017/01/02 00:00 [received]
PHST- 2017/01/11 00:00 [revised]
PHST- 2017/01/17 00:00 [accepted]
PHST- 2017/07/05 06:00 [entrez]
PHST- 2017/07/05 06:00 [pubmed]
PHST- 2017/07/05 06:01 [medline]
PHST- 2017/04/13 00:00 [pmc-release]
AID - openhrt-2017-000588 [pii]
AID - 10.1136/openhrt-2017-000588 [doi]
PST - epublish
SO  - Open Heart. 2017 Apr 13;4(1):e000588. doi: 10.1136/openhrt-2017-000588. 
      eCollection 2017.