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Vol 19 (2024): Continuous Publishing
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Published online: 2023-11-08

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Predictive factors of short-term mortality after surgical aortic valve replacement: a 10-year tertiary care hospital experience

Magdalena Anna Misztal-Teodorczyk1, Radosław Zwoliński1, Dawid Teodorczyk1, Ewa Oszczygieł2, Jarosław Drożdż1, Katarzyna Piestrzeniewicz1
DOI: 10.5603/fc.96873


Introduction. Aortic valve replacement (AVR) is a standard surgical procedure for symptomatic severe aortic stenosis (AS). This study aimed to identify predictors of short-term mortality after AVR. The pre-surgical risk stratification in patients with symptomatic severe AS may help decide on the most adequate treatment.

Material and methods. A retrospective, observational study included 1171 patients who underwent surgical AVR in a large tertiary medical centre over 10 years (2009–2019). The early mortality defined as the mortality within one month after surgery was analysed.

Results. The mean age of the study group was 64 (± 10) years. The most common aetiology of the aortic valve disease was a degenerative process (78.9%). The postoperative complication rate was 19.1% and the short-term mortality rate was 3.4%. An increased risk of short-term mortality after AVR was related to type 2 diabetes (6.1% vs. 2.6%; p = 0.006), chronic kidney disease (stage 3 to 5; 25% vs. 2.8%; p < 0.001), history of percutaneous coronary intervention (PCI) (8.2% vs. 3.1%; p = 0.045), active infective endocarditis (20.5% vs. 2.9%; p = 0.007), significant mitral (24% vs. 2.6%; p < 0.001) and tricuspid regurgitation (25.7% vs. 2.9%; p = 0.001), periprocedural complications (15.4% vs. 0.5%; p < 0.001), and emergency AVR (11.3% vs. 2.7%; p = 0.001). The independent predictors of short-term mortality identified by multivariate analysis were active infective endocarditis (odds ratio [OR]: 4.99; p = 0.045), duration of the surgical procedure (OR: 1.00; p = 0.018) and New York Heart Association (NYHA) class III–IV (OR: 1.97; p = 0.01).

Conclusions. Active infective endocarditis, duration of the surgical procedure and NYHA class III-IV are the independent predictors of short-term mortality after AVR and should be considered in deciding on the most adequate treatment.

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