Autor:

Ennker J, Rosendahl U, Bauer S, Dalladaku F, Ennker IC, Florath I

Erscheinungsort:

Thorac Cardiovase Surg 2002; 50 Suppl. 1: S47-S49
© Georg Thieme Verlag Stuttgart - New York. ISSN 0946-4778

Inhalt:

Heart lnstitute Lahr, Lahr, Germany

Objective: Determinants of operative mortality after aortic valve replacements (AVR) alter with the changing patient population due to advanced operative management and the increased lifeexpectancy. In order to predict the current "high risk" in groups of patients on a statistical valid base large study populations recruited over a short period of time are required.

Methods: Between January 1996 and June 2001, 1410 patients underwent AVR (573 of them with concomitant CABG). The data were analyzed by multivariate logistic regression to evaluate the operative risk, the mean age of the study population was 68 ± 11 years (range 19-90, 44% female).

Results: The overall operative mortality (within 30 days) was 3.8%. Independent predictive factors of operative death are shown in the table below. Concomitant CABG (p=0.56), previous AVR (p=0.64) and implantation of biological prostheses (p=0.31) were no risk factors. Including interaction terms as female by body mass index (BMI) greater than 29 by concomitant CABG (p=0.011, Odds Ratio: 3.4) and age over 71 years by body size smaller than 1.56 m (p=0.034, Odds Ratio: 2.3), where each term represent a "high risk"-group of patients, the model improved significantly (p= 0.01).

Conclusion: In contrast to older studies: the age with an increased operative risk was advanced to 80 years, an increased risk had women only with a BMI greater than 29 and receiving concomitant CABG and small persons older than 71 years probably due to their small aortic annulus.