Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre
Abstract Background This study examined the characteristics and outcomes of surgical aortic valve replacement (SAVR) both isolated and in combination with other cardiac surgery in Malaysia from 2015 to 2021. Methods This was a retrospective study of 1346 patients analyzed on the basis of medical rec...
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02472-2 |
| _version_ | 1797362927825584128 |
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| author | Aslannif Roslan Chong Kee Soon Tey Yee Sin Ahmad Tantawi Jauhari Aktifanus Soh Si Ling Wong Kian Boon Beni I. Rusani Hafidz Abd Hadi Jayakhanthan Kolanthaivelu Shaiful Azmi Yahaya Jeswant Dillon Alwi M. Yunus |
| author_facet | Aslannif Roslan Chong Kee Soon Tey Yee Sin Ahmad Tantawi Jauhari Aktifanus Soh Si Ling Wong Kian Boon Beni I. Rusani Hafidz Abd Hadi Jayakhanthan Kolanthaivelu Shaiful Azmi Yahaya Jeswant Dillon Alwi M. Yunus |
| author_sort | Aslannif Roslan |
| collection | DOAJ |
| description | Abstract Background This study examined the characteristics and outcomes of surgical aortic valve replacement (SAVR) both isolated and in combination with other cardiac surgery in Malaysia from 2015 to 2021. Methods This was a retrospective study of 1346 patients analyzed on the basis of medical records, echocardiograms and surgical reports. The overall sample was both considered as a whole and divided into aortic stenosis (AS)/aortic regurgitation (AR)-predominant and similar-severity subgroups. Results The most common diagnosis was severe AS (34.6%), with the 3 most common etiologies being bicuspid valve degeneration (45.3%), trileaflet valve degeneration (36.3%) and rheumatic valve disease (12.2%). The second most common diagnosis was severe AR (25.5%), with the most common etiologies being root dilatation (21.0%), infective endocarditis (IE) (16.6%) and fused prolapse (12.2%). Rheumatic valve disease was the most common mixed disease. A total of 54.5% had AS-predominant pathology (3 most common etiologies: bicuspid valve degeneration valve, degenerative trileaflet valve and rheumatic valve disease), 36.9% had AR-predominant pathology (top etiologies: root dilatation, rheumatic valve disease and IE), and 8.6% had similar severity of AS and AR. Overall, 62.9% of patients had trileaflet valve morphology, 33.3% bicuspid, 0.6% unicuspid and 0.3% quadricuspid. For AS, the majority were high-gradient severe AS (49.9%), followed by normal-flow low-gradient (LG) severe AS (10.0%), paradoxical low-flow (LF)-LG severe AS (6.4%) and classical LF-LG severe AS (6.1%). The overall in-hospital and total 1-year mortality rates were 6.4% and 14.8%, respectively. Pure severe AS had the highest mortality. For AS-predominant pathology, the etiology with the highest mortality was trileaflet valve degeneration; for AR-predominant pathology, it was dissection. The overall survival probability at 5 years was 79.5% in all patients, 75.7% in the AS-predominant subgroup, 83.3% in the AR-predominant subgroup, and 87.3% in the similar-severity subgroup. Conclusions The 3 most common causes of AS- predominant patients undergoing SAVR is bicuspid valve degeneration, degenerative trileaflet valve and rheumatic and for AR-predominant is root dilatation, rheumatic and IE. Rheumatic valve disease is an important etiology in our SAVR patients especially in mixed aortic valve disease. Study registration IJNREC/562/2022. |
| first_indexed | 2024-03-08T16:13:26Z |
| format | Article |
| id | doaj.art-8645e8f5aa814a02bf0fa0edfeda74f1 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-08T16:13:26Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-8645e8f5aa814a02bf0fa0edfeda74f12024-01-07T12:46:37ZengBMCJournal of Cardiothoracic Surgery1749-80902024-01-0119111510.1186/s13019-023-02472-2Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centreAslannif Roslan0Chong Kee Soon1Tey Yee Sin2Ahmad Tantawi Jauhari Aktifanus3Soh Si Ling4Wong Kian Boon5Beni I. Rusani6Hafidz Abd Hadi7Jayakhanthan Kolanthaivelu8Shaiful Azmi Yahaya9Jeswant Dillon10Alwi M. Yunus11Department of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraDepartment of Cardiology and Department of Cardiothoracic Surgery, Institut Jantung NegaraAbstract Background This study examined the characteristics and outcomes of surgical aortic valve replacement (SAVR) both isolated and in combination with other cardiac surgery in Malaysia from 2015 to 2021. Methods This was a retrospective study of 1346 patients analyzed on the basis of medical records, echocardiograms and surgical reports. The overall sample was both considered as a whole and divided into aortic stenosis (AS)/aortic regurgitation (AR)-predominant and similar-severity subgroups. Results The most common diagnosis was severe AS (34.6%), with the 3 most common etiologies being bicuspid valve degeneration (45.3%), trileaflet valve degeneration (36.3%) and rheumatic valve disease (12.2%). The second most common diagnosis was severe AR (25.5%), with the most common etiologies being root dilatation (21.0%), infective endocarditis (IE) (16.6%) and fused prolapse (12.2%). Rheumatic valve disease was the most common mixed disease. A total of 54.5% had AS-predominant pathology (3 most common etiologies: bicuspid valve degeneration valve, degenerative trileaflet valve and rheumatic valve disease), 36.9% had AR-predominant pathology (top etiologies: root dilatation, rheumatic valve disease and IE), and 8.6% had similar severity of AS and AR. Overall, 62.9% of patients had trileaflet valve morphology, 33.3% bicuspid, 0.6% unicuspid and 0.3% quadricuspid. For AS, the majority were high-gradient severe AS (49.9%), followed by normal-flow low-gradient (LG) severe AS (10.0%), paradoxical low-flow (LF)-LG severe AS (6.4%) and classical LF-LG severe AS (6.1%). The overall in-hospital and total 1-year mortality rates were 6.4% and 14.8%, respectively. Pure severe AS had the highest mortality. For AS-predominant pathology, the etiology with the highest mortality was trileaflet valve degeneration; for AR-predominant pathology, it was dissection. The overall survival probability at 5 years was 79.5% in all patients, 75.7% in the AS-predominant subgroup, 83.3% in the AR-predominant subgroup, and 87.3% in the similar-severity subgroup. Conclusions The 3 most common causes of AS- predominant patients undergoing SAVR is bicuspid valve degeneration, degenerative trileaflet valve and rheumatic and for AR-predominant is root dilatation, rheumatic and IE. Rheumatic valve disease is an important etiology in our SAVR patients especially in mixed aortic valve disease. Study registration IJNREC/562/2022.https://doi.org/10.1186/s13019-023-02472-2EchocardiographyAortic valveProsthesisEtiologyLow gradient |
| spellingShingle | Aslannif Roslan Chong Kee Soon Tey Yee Sin Ahmad Tantawi Jauhari Aktifanus Soh Si Ling Wong Kian Boon Beni I. Rusani Hafidz Abd Hadi Jayakhanthan Kolanthaivelu Shaiful Azmi Yahaya Jeswant Dillon Alwi M. Yunus Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre Journal of Cardiothoracic Surgery Echocardiography Aortic valve Prosthesis Etiology Low gradient |
| title | Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre |
| title_full | Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre |
| title_fullStr | Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre |
| title_full_unstemmed | Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre |
| title_short | Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre |
| title_sort | surgical aortic valve replacement etiologies hemodynamics and outcomes in 1346 patients from the malaysian heart centre |
| topic | Echocardiography Aortic valve Prosthesis Etiology Low gradient |
| url | https://doi.org/10.1186/s13019-023-02472-2 |
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