Thorac Cardiovasc Surg 2011; 59(4): 229-232
DOI: 10.1055/s-0030-1250640
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Contemporary Results for Isolated Aortic Valve Surgery

M. Gaudino1 , A. Anselmi1 , F. Glieca1 , V. Tsiopoulos1 , C. Pragliola1 , M. Morelli1 , G. Possati1
  • 1Division of Cardiac Surgery, Catholic University, Rome, Italy
Further Information

Publication History

received August 30, 2010

Publication Date:
15 March 2011 (online)

Abstract

Background: We aimed to give an overview of the contemporary status of aortic valve replacement. Materials and Methods: This single-center prospective study was initiated in January 2003. From this date on, every patient with aortic valve disease admitted to our hospital was reviewed by a cardiologist and a surgeon to determine eligibility for replacement. In no instance was the operation denied in the absence of surgical consultation. All operations were performed using a median sternotomy, with cardiopulmonary bypass and cardioplegic arrest. Results: A total of 873 cases were screened until the end of the study. We identified three groups of patients: Group 1 (inoperable cases) consisted of 15 patients (1 %); Group 2 (high-risk cases) included 99 patients with an additive EuroSCORE ≥ 10 or an expected mortality > 20 % (logistic model); Group 3 (moderate- to low-risk cases) consisted of 759 patients with an additive EuroSCORE < 10 or an expected mortality < 20 %. In-hospital mortality was 6.0 % (6/99) for Group 2 and 0.3 % (3/759) for Group 3. Major complications occurred in 5 patients of Group 2 (5 %) and in 9 patients of Group 3 (1.1 %). At predischarge echocardiography, 99.3 % of the implanted valves were perfect. At a follow-up of 28.9 ± 12.3 months 798/849 patients were alive; 89 % of them (711) were in NYHA 1–2. Conclusions: Surgical aortic valve replacement provides excellent results and has a low operative mortality even in high-risk patients. Surgical consultation for every aortic patient resulted in an extremely low rate of surgery refusals. Our data should be regarded as a benchmark for transcatheter techniques.

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Dr. Mario Gaudino, MD

Division of Cardiac Surgery
Catholic University

Largo A. Gemelli 8

00168 Rome

Italy

Phone: +39 6 30 15 48 14

Fax: +39 6 30 15 58 81

Email: mgaudino@tiscali.it