PMID- 35917823 OWN - NLM STAT- MEDLINE DCOM- 20240404 LR - 20240404 IS - 1439-1902 (Electronic) IS - 0171-6425 (Linking) VI - 72 IP - 3 DP - 2024 Apr TI - Impact of Procedure Volume on the Outcomes of Surgical Aortic Valve Replacement. PG - 173-180 LID - 10.1055/s-0042-1754352 [doi] AB - BACKGROUND: Literature demonstrated that procedure volumes affect outcomes of patients undergoing transcatheter aortic valve implantation. We evaluated the outcomes of surgical aortic valve replacement. METHODS: All isolated surgical aortic valve replacement procedures in Germany in 2017 were identified. Hospitals were divided into five groups from 100 (very high volume) annual procedures. RESULTS: In 2017, 5,533 patients underwent isolated surgical aortic valve replacement. All groups were of comparable risk (logistic EuroSCORE, 5.12-4.80%) and age (66.6-68.1 years). In-hospital mortality and complication rates were lowest in the very high-volume group. Multivariable logistic regression analyses showed no significant volume-outcome relationship for in-hospital mortality, stroke, postoperative delirium, and mechanical ventilation > 48 hours. Regarding acute kidney injury, patients in the very high-volume group were at lower risk than those in the very low volume group (odds ratio [OR] = 0.53, p = 0.04). Risk factors for in-hospital mortality were previous cardiac surgery (OR = 5.75, p < 0.001), high-grade renal disease (glomerular filtration rate < 15 mL/min, OR = 5.61, p = 0.002), surgery in emergency cases (OR = 2.71, p = 0.002), and higher grade heart failure (NYHA [New York Heart Association] III/IV; OR = 1.80, p = 0.02). Risk factors for all four complication rates were atrial fibrillation and diabetes mellitus. CONCLUSION: Patients treated in very low volume centers (100 operations/year). Only in the case of acute kidney injury, very high-volume centers showed better outcomes than very low volume centers. Therefore, surgical aortic valve replacement can be performed safely independent of case volume. CI - Thieme. All rights reserved. FAU - Oettinger, Vera AU - Oettinger V AUID- ORCID: 0000-0003-4460-2102 AD - Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Kaier, Klaus AU - Kaier K AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany. FAU - von Zur Muhlen, Constantin AU - von Zur Muhlen C AD - Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Zehender, Manfred AU - Zehender M AD - Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Bode, Christoph AU - Bode C AD - Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Beyersdorf, Friedhelm AU - Beyersdorf F AD - Department of Cardiac and Vascular Surgery, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Stachon, Peter AU - Stachon P AD - Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. AD - Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology I, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. FAU - Bothe, Wolfgang AU - Bothe W AD - Department of Cardiac and Vascular Surgery, University Heart Center Freiburg, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany. LA - eng PT - Journal Article DEP - 20220802 PL - Germany TA - Thorac Cardiovasc Surg JT - The Thoracic and cardiovascular surgeon JID - 7903387 SB - IM MH - Humans MH - Aged MH - Aortic Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis Implantation MH - *Aortic Valve Stenosis/diagnostic imaging/surgery MH - Treatment Outcome MH - *Transcatheter Aortic Valve Replacement MH - Risk Factors MH - *Acute Kidney Injury/etiology MH - Hospital Mortality COIS- None declared. EDAT- 2022/08/03 06:00 MHDA- 2024/04/04 06:45 CRDT- 2022/08/02 18:52 PHST- 2024/04/04 06:45 [medline] PHST- 2022/08/03 06:00 [pubmed] PHST- 2022/08/02 18:52 [entrez] AID - 10.1055/s-0042-1754352 [doi] PST - ppublish SO - Thorac Cardiovasc Surg. 2024 Apr;72(3):173-180. doi: 10.1055/s-0042-1754352. Epub 2022 Aug 2.