Predictors of Early Mortality After Aortic Valve Replacement in Middle-Aged Rheumatic Patients

Essam Hassan; Sameh   Sersar

doi:10.35810/ects.v1i3.71

Essam Hassan Department of Cardiothoracic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt. Prince Sultan Cardiac Center, Riyadh, KSA
Sameh Sersar Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt. King AbdAlla Medical City, Makka AlMukarma, KSA

DOI: https://doi.org/10.35810/ects.v1i3.71

Keywords: Aortic valve replacement, Risk scores, Euroscore II, Rheumatic heart disease

Abstract

Background: Several risk factors, including emergency surgery, predicted early mortality after aortic valve replacement (AVR). Euroscore II is used to predict the mortality after cardiac operations. We aimed to review our experience in AVR and determine the early mortality predictors

Methods: We collected the data of 200 rheumatic patients who had standard AVR in two centers. Median sternotomy and cardiopulmonary bypass were used in all patients. Transcatheter and minimally invasive aortic valve replacement patients were excluded. We used 15 types of aortic valve prostheses, either mechanical or biological. Follow-up echocardiography was done in the intensive care unit, on discharge, and one month after discharge.

Results: 128 patients (64%) had mechanical AVR, and 130 patients (65%) were males. The mean age was 48.2 ± 19 years, and body mass index was 1.8 ± 0.2 Kg/m2. The mean preoperative ejection fraction was 54 ± 9.4 %, end-diastolic dimension was 5.3 ± 0.8 cm, and end-systolic dimension was 3.5 ± 0.9 cm. Nine patients (4.5%) died in the early postoperative period (6 months). Euroscore II was the only factor significantly associated with early mortality (P value= 0.031). The mean Euroscore II was 1.3 ± 0.9 and 10.1 ± 10.7 for survivors and non-survivors, respectively.

Conclusion: Euroscore II score was significantly associated with early mortality after aortic valve replacement in rheumatic patients and can be used for risk stratification in those patients.