Data from 2256 patients undergoing primary isolated aortic valve replacement between January 2003 and December 2007 were prospectively collected in a Regional Registry (Regione Emilia Romagna Interventi Cardiochirurgia) and analyzed to estimate hospital and mid-term results.
Overall hospital mortality was 2.2 % . By multivariate analysis, New York Heart Association III and IV, Canadian Cardiovascular Society III and IV, pulmonary artery pressure greater than 60 mm Hg, dialysis, central neurologic dysfunction, and severe chronic obstructive pulmonary disease emerged as independent predictors of hospital mortality. At 3 years, the survival was 89.3 % . The same predictors of hospital mortality plus ejection fraction of 30 % to 50 % and age more than 80 years emerged as independent risk factors for 3-year mortality. Compared with younger patients, octogenarians had a higher hospital mortality rate (3.72 % vs 1.81 % ; P = .0143) and a reduced 3-year survival (82.3 % vs 91.3 % ; P < .001). Three-year survival of octogenarians was comparable to the expected survival of an age- and gender-matched regional population (P = .157). The observed mortality rate in octogenarians with a logistic European System for Cardiac Operative Risk Evaluation greater than 15 % (mean: 22.4 % ) was 7 % (P < .001).
This study provides contemporary data on the characteristics and outcome of patients undergoing first-time isolated aortic valve replacement.