Aortic valve replacement for aortic stenosis in Iceland 2002-2006: Long term complications and survival

• Published in: Laeknabladid Vol. 97; no. 11; pp. 591 - 595
• Main Authors: Viktorsson, Sindri Aron, Ingvarsdóttir, Inga Lára, Hreinsson, Kári, Sigurdsson, Martin Ingi, Helgadóttir, Sólveig, Arnorsson, Pórarinn, Danielsen, Ragnar, Gudbjartsson, Tómas
• Format: Journal Article
• Language: Icelandic
• Published: Iceland 01-11-2011
• Subjects: Aged; Aortic Valve Stenosis - diagnosis; Aortic Valve Stenosis - mortality; Aortic Valve Stenosis - surgery; Bioprosthesis; Female; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - mortality; Humans; Iceland - epidemiology; Logistic Models; Male; Patient Readmission; Risk Assessment; Risk Factors; Survival Rate; Time Factors; Treatment Outcome; Iceland
• ISSN: 0023-7213
• DOI: 10.17992/lbl.2011.11.395

To investigate long-term complications and survival following aortic valve replacement (AVR) in patients with aortic stenosis (AS) in Iceland.
Included were 156 patients (average age 71.7 yrs, 64.7% males) that underwent AVR for AS at Landspitali between 2002 and 2006. A mechanical prosthesis was used in 29 patients (18.6%) and a bioprosthesis in 127. Long-term complications and operation-related admissions were registered from hospital and outpatient records until April 1, 2010. Overall survival was estimated and compared with the Icelandic population of the same age and gender.
The mean preop. EuroSCORE(st) was 6.9%, the max. transvalvular pressure gradient 74.1 mmHg and the left ventricular ejection fraction (LVEF) (57.2%). At six months following AVR the maximal pressure gradient was 19.8 mmHg (range; 2.5-38). Echocardiography results were not available for 23.6% of the patients 6 months postoperatively. In the follow-up period one in four patients was admitted due to valve-related problems. Re-admission rate was 6.0/100 patient-years (pt-y); most commonly due to cardiac failure (1.7/100 pt-y), emboli (1.6/100 pt-y), hemorrhage (1.6/100 pt-y), endocarditis (0.7/100 pt-y) and myocardial infarction (0.4/100 pt-y). Survival at 1 and 5 year was 89.7% and 78.2%, respectively, making survival comparable to the estimated survival of Icelanders of the same age and gender.
The rate of long-term complications following AVR in Iceland is in line with other studies. The same applies to long-term survival, which was similar to that of the Icelandic population of the same age and gender. Key words: Aortic valve replacement, aortic stenosis, heart surgery, results, long-term complication, survival.