Impact of explanted valve type on aortic valve reoperations: nationwide UK experience

Abstract OBJECTIVES This nationwide retrospective cohort study assessed the impact of the explanted valve type on reoperative outcomes in aortic valve surgery within the UK over a 23-year period. METHODS Data were sourced from the National Institute for Cardiovascular Outcomes Research (NICOR) datab...

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Published in:European journal of cardio-thoracic surgery 2024-02, Vol.65 (2)
Main Authors: Narayan, Pradeep, Dong, Tim, Dimagli, Arnaldo, Fudulu, Daniel P, Chan, Jeremy, Sinha, Shubhra, Angelini, Gianni D
Format: Article
Language:English
Subjects:
Aortic Valve - surgery
Bioprosthesis - adverse effects
Conventional Valve Operations
Endocarditis - surgery
Heart Valve Prosthesis - adverse effects
Heart Valve Prosthesis Implantation - adverse effects
Humans
Reoperation
Retrospective Studies
Stroke Volume
Treatment Outcome
United Kingdom - epidemiology
Ventricular Function, Left
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Summary:Abstract OBJECTIVES This nationwide retrospective cohort study assessed the impact of the explanted valve type on reoperative outcomes in aortic valve surgery within the UK over a 23-year period. METHODS Data were sourced from the National Institute for Cardiovascular Outcomes Research (NICOR) database. All patients undergoing first-time isolated reoperative aortic valve replacement between 1996 and 2019 in the UK were included. Concomitant procedures, homograft implantation or aortic root enlargement were excluded. Propensity score matching was utilized to compare outcomes and risk factors for in-hospital mortality was evaluated through multivariable logistic regression. Final model selection was conducted using Akaike Information Criterion through bootstrapping. The primary end point was in-hospital mortality, and secondary end points included postoperative morbidities. RESULTS Out of 2371 patients, 24.9% had mechanical and 75% had bioprosthetic valves implanted during the primary procedure. Propensity matched groups of 324 patients each, were compared. In-hospital mortality for mechanical and bioprosthetic valve explants was 7.1% and 5.9%, respectively (P = 0.632). On multivariable logistic regression analysis, valve type was not a risk factor for mortality [odds ratio (OR) 0.62, 95% confidence interval (CI) 0.37–1.05; P = 0.1]. Age (OR 1.03, 95% CI 1.01–1.05; P 
ISSN:1873-734X
1010-7940
1873-734X
DOI:10.1093/ejcts/ezae031