Mid-term follow-up and outcomes of patients with prosthetic heart valves: a single-centre experience.

Echocardiography Patient outcomes Prosthetic heart valves

Journal

Echo research and practice
ISSN: 2055-0464
Titre abrégé: Echo Res Pract
Pays: England
ID NLM: 101664713

Informations de publication

Date de publication:
06 Jun 2022
Historique:
received: 14 10 2021
accepted: 21 03 2022
entrez: 6 6 2022
pubmed: 7 6 2022
medline: 7 6 2022
Statut: epublish

Résumé

Patients with prosthetic heart valves (PHV) require long-term follow-up, usually within a physiologist led heart valve surveillance clinic. These clinics are well established providing safe and effective patient care. The disruption of the COVID-19 pandemic on services has increased wait times thus we undertook a service evaluation to better understand the patients currently within the service and PHV related complications. A clinical service evaluation of the heart valve surveillance clinic was undertaken to assess patient demographics, rates of complications and patient outcomes in patients who had undergone a PHV intervention at our institute between 2010 and 2020. A total of 294 patients (mean age at time of PHV intervention: 71 ± 12 years, 68.7% male) were included in this service evaluation. Follow-up was 5.9 ± 2.7 years (range: 10 years). 37.1% underwent baseline transthoracic echo (TTE) assessment and 83% underwent annual TTE follow-up. Significant valve related complications were reported in 20 (6.8%) patients. Complications included a change in patient functional status secondary to significant PHV regurgitation (0.3%) or stenosis (0.3%), PHV thrombosis (0.3%) or infective endocarditis (3.7%). Significant valve related complications resulted in ten hospital admission (3.4%), two re-do interventions (0.6%), and four deaths (1.3%). This service evaluation highlights the large number of patients requiring ongoing surveillance. Only a small proportion of patients develop significant PHV related complications resulting in a low incidence of re-do interventions and deaths.

Sections du résumé

BACKGROUND BACKGROUND
Patients with prosthetic heart valves (PHV) require long-term follow-up, usually within a physiologist led heart valve surveillance clinic. These clinics are well established providing safe and effective patient care. The disruption of the COVID-19 pandemic on services has increased wait times thus we undertook a service evaluation to better understand the patients currently within the service and PHV related complications.
METHODS METHODS
A clinical service evaluation of the heart valve surveillance clinic was undertaken to assess patient demographics, rates of complications and patient outcomes in patients who had undergone a PHV intervention at our institute between 2010 and 2020.
RESULTS RESULTS
A total of 294 patients (mean age at time of PHV intervention: 71 ± 12 years, 68.7% male) were included in this service evaluation. Follow-up was 5.9 ± 2.7 years (range: 10 years). 37.1% underwent baseline transthoracic echo (TTE) assessment and 83% underwent annual TTE follow-up. Significant valve related complications were reported in 20 (6.8%) patients. Complications included a change in patient functional status secondary to significant PHV regurgitation (0.3%) or stenosis (0.3%), PHV thrombosis (0.3%) or infective endocarditis (3.7%). Significant valve related complications resulted in ten hospital admission (3.4%), two re-do interventions (0.6%), and four deaths (1.3%).
CONCLUSIONS CONCLUSIONS
This service evaluation highlights the large number of patients requiring ongoing surveillance. Only a small proportion of patients develop significant PHV related complications resulting in a low incidence of re-do interventions and deaths.

Identifiants

pubmed: 35659315
doi: 10.1186/s44156-022-00001-w
pii: 10.1186/s44156-022-00001-w
pmc: PMC9167640
doi:

Types de publication

Journal Article

Langues

eng

Pagination

1

Informations de copyright

© 2022. The Author(s).

Références

Echo Res Pract. 2018 Sep;5(3):113-119
pubmed: 29976783
Eur Heart J. 2017 Sep 21;38(36):2739-2791
pubmed: 28886619
J Am Soc Echocardiogr. 2009 Sep;22(9):975-1014; quiz 1082-4
pubmed: 19733789
Echo Res Pract. 2019 Dec 1;6(4):E1-E2
pubmed: 31725409
Open Heart. 2020 Apr 20;7(1):e001262
pubmed: 32399252
Echo Res Pract. 2019 Mar 1;6(1):G9-G15
pubmed: 30763277
Curr Probl Cardiol. 2000 Feb;25(2):73-154
pubmed: 10709140
Prog Cardiovasc Dis. 2008 Jan-Feb;50(4):274-81
pubmed: 18156006

Auteurs

Sadie Bennett (S)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK. Sadie.Bennett@uhnm.nhs.uk.

Polyvios Demetriades (P)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Keely Banks (K)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Jacopo Tafuro (J)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Rosie Oatham (R)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.
Keele University, Stoke-on-Trent, UK.

Timothy Griffiths (T)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Cheryl Oxley (C)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Sally Clews (S)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Grant Heatlie (G)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.

Chun Shing Kwok (CS)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.
Keele University, Stoke-on-Trent, UK.

Simon Duckett (S)

Heart & Lung Centre, Royal Stoke University Hospital, University Hospitals of North Midlands, Newcastle Road, Stoke-on-Trent, UK.
Keele University, Stoke-on-Trent, UK.

Classifications MeSH