Coronary revascularization after surgical aortic valve replacement.
AS, aortic valve stenosis
CABG, coronary artery bypass grafting
CAD, coronary artery disease
LVEF, left ventricular ejection fraction
PCI, percutaneous coronary intervention
SAVR, surgical aortic valve replacement
TAVR, transcatheter aortic valve replacemen
aortic stenosis
aortic valve replacement
coronary artery bypass grafting
percutaneous coronary intervention
transcatheter
Journal
JTCVS open
ISSN: 2666-2736
Titre abrégé: JTCVS Open
Pays: Netherlands
ID NLM: 101768541
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
08
05
2020
revised:
08
05
2020
accepted:
08
05
2020
entrez:
25
8
2022
pubmed:
29
5
2020
medline:
29
5
2020
Statut:
epublish
Résumé
It remains unclear how often coronary revascularization is necessary after aortic valve interventions, either by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement. However, these data are relevant for treatment and prosthesis choice. The authors sought to analyze the incidence and characteristics of coronary revascularization after SAVR during follow-up. Of 2256 patients undergoing isolated SAVR between 1987 and 2015, 420 patients (mean age 56.9 ± 15.5 years, 66.9% male) were followed at the Erasmus Medical Center. Incidence, predictors, and characteristics of coronary revascularization were analyzed. Cumulative incidence of revascularization was assessed using a competing risk approach. Mean follow-up after SAVR was 17.2 years (total of 4541 patient-years). A total of 24 patients underwent 28 procedures of revascularization. The cumulative incidence of revascularization after SAVR was 0.5%, 2.2%, 4.1%, and 6.9% at 1, 5, 10, and 20 years, respectively. The linearized rate of revascularization was 6.2 per 1000 patient-years. Percutaneous coronary intervention was the most common revascularization method (64%; N = 18/28). Revascularization before SAVR (N = 36/420; of whom 27 percutaneous coronary intervention) was an independent predictor of revascularization during follow-up (hazard ratio, 6.6; 95% confidence interval, 2.6-17.1; After SAVR, the rate of coronary revascularization was 6.9% (N = 24/420) at 20-year follow-up. Patients were at particular risk if they had undergone previous revascularization before SAVR. These data may furthermore be relevant to the transcatheter aortic valve replacement population.
Identifiants
pubmed: 36003865
doi: 10.1016/j.xjon.2020.05.005
pii: S2666-2736(20)30038-3
pmc: PMC9390258
doi:
Types de publication
Journal Article
Langues
eng
Pagination
91-101Informations de copyright
© 2020 The Authors.
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