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Type: Journal article
Title: Thirty years experience with heart valve surgery: isolated aortic valve replacement.
Author: Bessell, J.
Gower, G.
Craddock, D.
Stubberfield, J.
Maddern, G.
Citation: Australian and New Zealand Journal of Surgery, 1996; 66(12):799-805
Issue Date: 1996
ISSN: 0004-8682
Abstract: <h4>Background</h4>Thirty years have elapsed since the commencement of open-heart surgery in South Australia. A retrospective study was performed to evaluate mortality and complication rates and to identify factors associated with poor outcomes in all patients who underwent prosthetic aortic valve replacement during this period.<h4>Methods</h4>Questionnaires and personal contact have been used to generate a combined database of pre-operative and post-operative information and long-term follow-up on 1322 patients who underwent isolated prosthetic aortic valve replacement at the Cardio-Thoracic Surgical Unit of the Royal Adelaide Hospital between 1963 and 1992.<h4>Results</h4>Complete survival follow-up data were obtained for 94% (1241) of the patients. The Bjork-Shiley valve was used in 66% (875) of the patients, a Starr-Edwards prosthesis in 31% (412), a St Jude prosthesis in 2% (26), and only 0.7% (9) bioprosthetic valves were inserted. The hospital mortality rate for the 30-year period was 2.9%. Progressively older and less fit patients have undergone surgery in recent years. The long-term survival of patients with aortic stenosis and aortic incompetence was not significantly different. Long-term survival was significantly shorter for patients with higher New York Heart Association (NYHA) functional classifications, and for patients in pre-operative atrial fibrillation. Pre-operative dyspnoea was significantly improved following aortic valve replacement. The rates of postoperative haemorrhagic and embolic complications were low by comparison with other published series.<h4>Conclusions</h4>Aortic valve replacement can be performed with low hospital mortality and complication rates, and significant symptomatic improvement can be expected. Aortic valve recipients have a favourable prognostic outcome compared with an age- and sex-matched population, and risk factors that determine long-term survival can be identified pre-operatively.
Keywords: Aortic Valve; Humans; Cardiovascular Diseases; Aortic Valve Insufficiency; Aortic Valve Stenosis; Embolism; Gastrointestinal Hemorrhage; Postoperative Complications; Hospitalization; Reoperation; Hospital Mortality; Survival Rate; Bioprosthesis; Heart Valve Prosthesis; Adolescent; Adult; Aged; Aged, 80 and over; Middle Aged; Child; Female; Male; Arrhythmias, Cardiac; Infections
RMID: 0030004699
DOI: 10.1111/j.1445-2197.1996.tb00753.x
Appears in Collections:Surgery publications

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