Aortic Valve Replacement Indicated For Patients Without Significant Risk

Ruzanna Harutyunyan's picture
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Patients who have aortic valve replacement (AVR) surgery but did not have other significant risk factors have a nearly identical 30-month survival rate as the general population, according to a study led by University at Albany Distinguished Professor Edward L. Hannan recently published in the Annals of Thoracic Surgery. The study, "Aortic Valve Replacement for Patients with Severe Aortic Stenosis: Risk Factors and Their Impact on 30-Month Mortality," found that patients who underwent AVR without any of a few severe risk factors had a risk-adjusted survival rate of 89.9 percent, nearly identical with the general population (90.0 percent).

Additionally, for people age 75 and over, the survival rate was 86.2 percent for patients who only required the AVR procedure.

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Patients with associated risk factors, such as advancing age, emergency status, low ejection fraction, congestive heart failure, or previous heart surgery faced significantly lower survival rates.

"Our study demonstrated that the medium-term mortality of AVR patients is excellent, and that for the large number of patients without high-risk conditions like congestive heart failure, low ejection fractions, a recent heart attack, or hemodynamic instability, the 30-month survival is essentially as high as that of an age-sex matched group of the U.S. population," said Dr. Hannan, distinguished professor of health policy, management and behavior at UAlbany's School of Public Health.

"Although we were not able to compare AVR patients to patients with aortic stenosis (the condition that precipitates the need for AVR) who did not undergo AVR, the fact that many AVR patients have been demonstrated to fare as well as an age-sex matched group of patients without aortic stenosis certainly indicates that AVR is an appropriate intervention for patients with the condition," said Dr. Hannan.

The study utilized the New York State Department of Health's Cardiac Surgery Reporting System database, and incorporated information from 6,369 patients. Hannan, who serves as the School of Public Health’s associate dean for research, is acclaimed nationally and internationally for bringing evidence-based medicine to the attention of practicing clinicians, and is a leading expert on health care quality and outcomes.

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