loading page

Impact of valve size, effective and indexed effective orifice area after aortic valve replacement.
  • +3
  • Suvitesh Luthra,
  • Pietro Malvindi,
  • Carlo Olevano,
  • Anna Zingale,
  • Hamdi Salem,
  • Sunil Ohri
Suvitesh Luthra
University Hospital Southampton NHS Foundation Trust

Corresponding Author:[email protected]

Author Profile
Pietro Malvindi
University Hospital Southampton NHS Foundation Trust
Author Profile
Carlo Olevano
University Hospital Southampton NHS Foundation Trust
Author Profile
Anna Zingale
University Hospital Southampton NHS Foundation Trust
Author Profile
Hamdi Salem
University Hospital Southampton NHS Foundation Trust
Author Profile
Sunil Ohri
University Hospital Southampton NHS Foundation Trust
Author Profile

Abstract

Introduction - The impact of manufacturer labelled prosthesis size and predicted effective orifice area (EOA) on long term survival after aortic valve replacement is not clear although indexed effective orifice area (iEOA) has been associated with worse survival. Methods - Data was retrospectively collected from Jan 2000 – Dec 2019 for prosthesis type, model and size for isolated aortic valve replacements. Stratified survival was compared between groups and subgroups for labelled valve size, EOA and predicted PPM. Results – Total of 3444 patients were included. Moderate and severe PPM was 15.6% and 1.6% respectively. Cumulative life time hazard was worse for biological valves (mortality: biological 77.7% vs mechanical 64.8%, p=0.001). Mean survival was 132.7 months for biological versus 191.3 months for mechanical valves (p=0.001). Moderate prosthetic AS (EOA = 1-1.5 cm2) was12.1% and severe prosthetic AS (EOA≤1 cm2) was 0.8% respectively. Worse survival in the presence of moderate-severe prosthetic AS was seen in biological valves (115.2 months versus 133.7 months, p=0.001 for EOA≤1.5cm2 and >1.5cm2 respectively). There was a statistically significant correlation between survival and iEOA (Spearman’s rho=0.084, p=0.001, BCa bootstrap 95% CI;0.050, 0.120). Moderate to severe PPM (iEOA≤0.85cm2/m2) was a predictor of worse long term survival (HR 3.56; 95% CI: 1.37 - 9.25; p=0.009). Conclusion - Predicted prosthetic moderate to severe AS and moderate to severe PPM adversely affect long term survival. Smaller valves are associated with reduced survival in all groups.
11 Aug 2020Submitted to Journal of Cardiac Surgery
11 Aug 2020Submission Checks Completed
11 Aug 2020Assigned to Editor
19 Aug 2020Reviewer(s) Assigned
03 Sep 2020Review(s) Completed, Editorial Evaluation Pending
21 Sep 2020Editorial Decision: Revise Major
04 Nov 20201st Revision Received
05 Nov 2020Submission Checks Completed
05 Nov 2020Assigned to Editor
13 Nov 2020Review(s) Completed, Editorial Evaluation Pending
19 Nov 2020Editorial Decision: Revise Major
23 Nov 20202nd Revision Received
25 Nov 2020Submission Checks Completed
25 Nov 2020Assigned to Editor
25 Nov 2020Review(s) Completed, Editorial Evaluation Pending
28 Nov 2020Editorial Decision: Revise Minor
30 Nov 20203rd Revision Received
01 Dec 2020Submission Checks Completed
01 Dec 2020Assigned to Editor
01 Dec 2020Review(s) Completed, Editorial Evaluation Pending
06 Dec 2020Editorial Decision: Accept