| Abstract [eng] |
The aim of the research: To evaluate in-hospital mortality and long – term survival after sortic valve (AoV) replacement. Objectives: To assess in-hospital mortality and 10-year survival of patients after aortic valve replacement operations. To assess the dependence between patients 10-year survival ant type of aortic valve. To evaluate a statistical relationship between in-hospital mortality and 10-year survival of patients after AoV surgeries with coronary artery bypass grafting (CABG) and without CABG. To assess the dependence of patients in-hospital mortality and/or long – term survival considering factors, which are mentioned as important or possibly important in the literature: type 2 diabetes mellitus (DM II) morbidity, long-term stay in the intensive care unit (ICU) after surgery, average gradient of the aortic valve (AVG media) after 1 year, cardiopulmonary bypass (CPB) and aortic cross-clamp duration (ACCD) Methods: Depersonalized data of patients after AoV prosthetics surgery, performed in 2011 – 2021 in Vilnius University Hospital Santaros Klinikos, was retrospectively analyzed. The study included 573 patients who underwent aortic replacement with and without CABG, and/or mitral valve replacement. All patients were divided into three age groups: <60 years (n=189), 60-69 years (n=242), >70 years (n=142). The patients were divided into 2 groups according to the median of ACCD (86 min). 107 patients ≥ 86 min. and 197 patients < 86 min. Patients were divided into 2 groups according to median of CPB (140 min). 114 patients ≥ 140 min. and 190 patients < 140 min. Prolonged ICU stay was defined as a postoperative stay of a patient in ICU > 5 days. Based on the AVG media values, the patients were divided into 3 groups: <10 mm/Hg (n=188), 10-19 mm/Hg (n=304), ≥ 20mm/Hg (n=81). Results: In-hospital mortality of patients after AoV surgery was 5.4% (n=31/573). The 5-year and 10-year survival rates were 78% and 54.6%, respectively. Survival did not differ between groups of patients with different valve type (p = 0.2). No statistically significant relationship was found between AoV surgery with CABG and in-hospital mortality (p = 0.1), and 10-year survival (p = 0.8). A statistically significant difference of in-hospital mortality (p = 0.043) and 10-year survival (p = 0.0008) was found between patients with diagnosed DM II and without DM II. A statistically significant dependence of in-hospital mortality and 10-year survival between prolonged ICU stay was found (p < 0.0001), (p = 0.0002), respectively. No AVG media groups, measured 1 year after surgery, dependence on 9-year survival was found (p = 0,1). No relationship of ACCD (p = 0.3) and CPB (p = 0.3) between 5-year survival was found. Conclusions: In-hospital mortality of patients after combined AoV replacement was 5.4% (n=31/573). The 5-year and 10-year survival rates were 78% and 54.6%, respectively. No satistically significant relationship between 10-year survival and valve type was found. There is no dependence of in-hospital mortality and 10-year survival between the groups of patients who underwent isolated AoV surgery and surgery with CABG. In-hospital mortality and 10-year survival depend on the DM II morbidity and prolonged ICU stay. There is no relationship between the AoV AVG media and 9-year survival. There is no relationship of the ACCD and CPB on 5-year survival. |
