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Open Access 01-02-2014 | Original Paper

Can postoperative mean transprosthetic pressure gradient predict survival after aortic valve replacement?

Authors: Bart M. Koene, Mohamed A. Soliman Hamad, Wobbe Bouma, Massimo A. Mariani, Kathinka C. Peels, Jan-Melle van Dantzig, Albert H. van Straten

Published in: Clinical Research in Cardiology | Issue 2/2014

Abstract

Background

In this study, we sought to determine the effect of the mean transprosthetic pressure gradient (TPG), measured at 6 weeks after aortic valve replacement (AVR) or AVR with coronary artery bypass grafting (CABG) on late all-cause mortality.

Methods

Between January 1998 and March 2012, 2,276 patients (mean age 68 ± 11 years) underwent TPG analysis at 6 weeks after AVR (n = 1,318) or AVR with CABG (n = 958) at a single institution. Mean TPG was 11.6 ± 7.8 mmHg and median TPG 11 mmHg. Based on the TPG, the patients were split into three groups: patients with a low TPG (<10 mmHg), patients with a medium TPG (10–19 mmHg) and patients with a high TPG (≥20 mmHg). Cox proportional-hazard regression analysis was used to determine univariate predictors and multivariate independent predictors of late mortality.

Results

Overall survival for the entire group at 1, 3, 5, and 10 years was 97, 93, 87 and 67 %, respectively. There was no significant difference in long-term survival between patients with a low, medium or high TPG (p = 0.258). Independent predictors of late mortality included age, diabetes, peripheral vascular disease, renal dysfunction, chronic obstructive pulmonary disease, a history of a cerebrovascular accident and cardiopulmonary bypass time. Prosthesis–patient mismatch (PPM), severe PPM and TPG measured at 6 weeks postoperatively were not significantly associated with late mortality.

Conclusions

TPG measured at 6 weeks after AVR or AVR with CABG is not an independent predictor of all-cause late mortality and there is no significant difference in long-term survival between patients with a low, medium or high TPG.

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Title: Can postoperative mean transprosthetic pressure gradient predict survival after aortic valve replacement?
Authors: Bart M. Koene
Mohamed A. Soliman Hamad
Wobbe Bouma
Massimo A. Mariani
Kathinka C. Peels
Jan-Melle van Dantzig
Albert H. van Straten
Publication date: 01-02-2014
Publisher: Springer Berlin Heidelberg
Published in: Clinical Research in Cardiology / Issue 2/2014
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-013-0629-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can postoperative mean transprosthetic pressure gradient predict survival after aortic valve replacement?

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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