Long-term follow-up of morbidity and mortality after aortic valve replacement with a mechanical valve prosthesis
(2000) In European Heart Journal 21(13). p.111-1099- Abstract
AIMS: The aim of this study was to determine the incidence of valve-related complications in patients with a mechanical aortic valve prosthesis and to identify risk factors for an adverse outcome.
METHODS AND RESULTS: In the 424 patients, event-free survival rates 5 and 10 years after aortic valve replacement were 62% and 37%, respectively. The linearized incidence of thromboembolic events was 4.4% per patient-year, and of anticoagulant-related haemorrhage 8.5% per patient-year. Advanced NYHA functional class, atrial fibrillation, pure aortic regurgitation and thromboembolism prior to surgery decreased event-free survival. A history of pre-operative thromboembolism increased the risk for a first embolic event after aortic valve... (More)
AIMS: The aim of this study was to determine the incidence of valve-related complications in patients with a mechanical aortic valve prosthesis and to identify risk factors for an adverse outcome.
METHODS AND RESULTS: In the 424 patients, event-free survival rates 5 and 10 years after aortic valve replacement were 62% and 37%, respectively. The linearized incidence of thromboembolic events was 4.4% per patient-year, and of anticoagulant-related haemorrhage 8.5% per patient-year. Advanced NYHA functional class, atrial fibrillation, pure aortic regurgitation and thromboembolism prior to surgery decreased event-free survival. A history of pre-operative thromboembolism increased the risk for a first embolic event after aortic valve replacement (relative hazard [RH] 3.2), but was even more strongly associated with the risk for repeated events (> or =2 events, RH 5.4). After each thromboembolic episode that occurred, the risk for a subsequent one was increased. The risk for at least one, and up to three or more haemorrhages was increased in patients with a pre-operative history of bleeding (RH 3.3-5.1) and of atrial fibrillation (RH 1.8-3.9). The risk for a subsequent event was increased by a history of repeated haemorrhages, a short interval since previous bleeding, and high age.
CONCLUSIONS: There were few factors strongly related to valve related morbidity. However, previous bleedings and previous thromboembolism were powerful risk factors for repeated events.
(Less)
- author
- Kvidal, P ; Bergström, R ; Malm, T LU and Ståhle, E
- publishing date
- 2000-07
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adolescent, Adult, Aged, Anticoagulants/adverse effects, Aortic Valve, Biocompatible Materials, Cause of Death, Child, Disease-Free Survival, Female, Follow-Up Studies, Heart Valve Diseases/surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation/mortality, Humans, Incidence, Intracranial Embolism and Thrombosis/etiology, Male, Middle Aged, Platelet Aggregation Inhibitors/adverse effects, Postoperative Hemorrhage/chemically induced, Prospective Studies, Prosthesis Failure, Survival Rate, Sweden/epidemiology
- in
- European Heart Journal
- volume
- 21
- issue
- 13
- pages
- 13 pages
- publisher
- Oxford University Press
- external identifiers
-
- pmid:10843828
- scopus:0034077473
- ISSN
- 0195-668X
- DOI
- 10.1053/euhj.2000.1862
- language
- English
- LU publication?
- no
- id
- edb9ec69-09b0-4ce1-9bbf-da6405e0c1b6
- date added to LUP
- 2018-12-05 14:55:54
- date last changed
- 2024-04-01 17:03:00
@article{edb9ec69-09b0-4ce1-9bbf-da6405e0c1b6,
abstract = {{<p>AIMS: The aim of this study was to determine the incidence of valve-related complications in patients with a mechanical aortic valve prosthesis and to identify risk factors for an adverse outcome.</p><p>METHODS AND RESULTS: In the 424 patients, event-free survival rates 5 and 10 years after aortic valve replacement were 62% and 37%, respectively. The linearized incidence of thromboembolic events was 4.4% per patient-year, and of anticoagulant-related haemorrhage 8.5% per patient-year. Advanced NYHA functional class, atrial fibrillation, pure aortic regurgitation and thromboembolism prior to surgery decreased event-free survival. A history of pre-operative thromboembolism increased the risk for a first embolic event after aortic valve replacement (relative hazard [RH] 3.2), but was even more strongly associated with the risk for repeated events (> or =2 events, RH 5.4). After each thromboembolic episode that occurred, the risk for a subsequent one was increased. The risk for at least one, and up to three or more haemorrhages was increased in patients with a pre-operative history of bleeding (RH 3.3-5.1) and of atrial fibrillation (RH 1.8-3.9). The risk for a subsequent event was increased by a history of repeated haemorrhages, a short interval since previous bleeding, and high age.</p><p>CONCLUSIONS: There were few factors strongly related to valve related morbidity. However, previous bleedings and previous thromboembolism were powerful risk factors for repeated events.</p>}},
author = {{Kvidal, P and Bergström, R and Malm, T and Ståhle, E}},
issn = {{0195-668X}},
keywords = {{Adolescent; Adult; Aged; Anticoagulants/adverse effects; Aortic Valve; Biocompatible Materials; Cause of Death; Child; Disease-Free Survival; Female; Follow-Up Studies; Heart Valve Diseases/surgery; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation/mortality; Humans; Incidence; Intracranial Embolism and Thrombosis/etiology; Male; Middle Aged; Platelet Aggregation Inhibitors/adverse effects; Postoperative Hemorrhage/chemically induced; Prospective Studies; Prosthesis Failure; Survival Rate; Sweden/epidemiology}},
language = {{eng}},
number = {{13}},
pages = {{111--1099}},
publisher = {{Oxford University Press}},
series = {{European Heart Journal}},
title = {{Long-term follow-up of morbidity and mortality after aortic valve replacement with a mechanical valve prosthesis}},
url = {{http://dx.doi.org/10.1053/euhj.2000.1862}},
doi = {{10.1053/euhj.2000.1862}},
volume = {{21}},
year = {{2000}},
}