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Life Expectancy Aft...
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Martinsson, AndreasGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
(author)
Life Expectancy After Surgical Aortic Valve Replacement.
- Article/chapterEnglish2021
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LIBRIS-ID:oai:gup.ub.gu.se/310031
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https://gup.ub.gu.se/publication/310031URI
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https://doi.org/10.1016/j.jacc.2021.09.861DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Surgical risk, age, perceived life expectancy, and valve durability influence the choice between surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation. The contemporaneous life expectancy after SAVR, in relation to surgical risk and age, is unknown.The purpose of this study was to determine median survival time in relation to surgical risk and chronological age in SAVR patients.Patients≥60 years with aortic stenosis who underwent isolated SAVR with a bioprosthesis (n=8,353) were risk-stratified before surgery into low, intermediate, or high surgical risk using the logistic EuroSCORE (2001-2011) or EuroSCORE II (2012-2017) and divided into age groups. Median survival time and cumulative 5-year mortality were estimated with Kaplan-Meier curves. Cox regression analysis was used to further determine the importance of age.There were 7,123 (85.1%) low-risk patients, 942 (11.3%) intermediate-risk patients, and 288 (3.5%) high-risk patients. Median survival time was 10.9 years (95% confidence interval: 10.6-11.2 years) in low-risk, 7.3 years (7.0-7.9years) in intermediate-risk, and 5.8 years (5.4-6.5 years) in high-risk patients. The 5-year cumulative mortality was 16.5% (15.5%-17.4%), 30.7% (27.5%-33.7%), and 43.0% (36.8%-48.7%), respectively. In low-risk patients, median survival time ranged from 16.2 years in patients aged 60 to 64 years to 6.1 years in patients aged≥85 years. Age was associated with 5-year mortality only in low-risk patients (interaction P< 0.001).Eighty-five percent of SAVR patients receiving bioprostheses have low surgical risk. Estimated survivalis substantial following SAVR, especially in younger, low-risk patients, which should be considered in Heart Teamdiscussions.
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Nielsen, Susanne,1969Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xniesu
(author)
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Milojevic, Milan
(author)
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Redfors, BjörnGothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Wallenberg Laboratory,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xredbj
(author)
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Omerovic, Elmir,1968Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Wallenberg Laboratory,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xomeel
(author)
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Tönnessen, Theis
(author)
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Gudbjartsson, Tomas
(author)
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Dellgren, Göran,1961Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xdelgo
(author)
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Jeppsson, Anders,1960Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Wallenberglaboratoriet,Institute of Medicine, Department of Molecular and Clinical Medicine,Wallenberg Laboratory(Swepub:gu)xjepan
(author)
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Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
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In:Journal of the American College of Cardiology: Elsevier BV78:22, s. 2147-21571558-35970735-1097
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