Abstract 4283: Outcomes of Patients Undergoing Concomitant Aortic and Mitral Valve Surgery in Northern New England
Background: During the past 20 years (yrs), there has been a steady increase in concomitant aortic(AV) and mitral valve(MV) surgery in northern New England (NNE). We examined the in-hospital and long-term mortality for these patients by procedure, patient age and sex.
Methods: This is a prospective, regional, cohort study of 1057 patients undergoing concomitant AV and MV surgery in NNE from 1989 through 2007. Long-term survival was obtained by linking our registry data to the Social Security Administration Death Master File. Kaplan-Meier and log-rank tests were performed.
Results: Patient characteristics: age <70 yrs (45.1%), 70–79 yrs (41.0%), and ≥ 80 yrs (13.9%); female sex (44.1%); associated CABG (46.9%); diabetes (19.5%); CHF (60.7%); PVD (17.7%); non dialysis renal failure (RF) (5.3%); dialysis dependant RF (2.4%). In-hospital mortality was 15.4% (11.0% for patients <70 yrs, 18.0% for 70–79 year olds, and 24% for those ≥80). The median period of follow-up was 3.5 yrs. Overall median survival was 7.3 yrs. Median survival for surgery without CABG was 9.5 yrs and 5.7 yrs with CABG (p<0.001). Survival among women was worse compared to men (7.3 v 9.3, yrs, p=0.033). Median survival by age group was 11.0 yrs for patients <70, 5.4 yrs for 70-79 year olds, and 4.8 for ≥ 80. Median survival was not significantly different for patients ≥ 80 compared to those 70–79 yrs old (p=0.245).
Conclusions: Double valve open heart surgery has a high in-hospital mortality rate. Long-term survival was decreased by having a concomitant CABG, being female and being 70 yrs or older. Although short-term mortality was higher, median survival for patients ≥ 80 yrs was equivalent to that for patients 70–79 yrs.