Developing Hemodynamic Valve Deterioration and Mortality in Aortic Valve Replacement

Background: As life span increases, in patients having a bioprosthetic valve, the develop-ment of hemodynamic valve deterioration (HVD) is an important concern. We evaluated the association of developing HVD to survival in patients undergoing surgical aortic valve replacement (SAVR). Methods: The individuals undergoing isolated SAVR and serial echocardiography exams (interval >30 d) were included in this study. HVD was defined as mean pressure gradient >= 20 mmHg, mean pressure gradient >= 10 mmHg higher than in the baseline exam, or more than moderate regurgitation on Doppler echocardiography (moderate and severe grade). A time-dependent Cox proportional hazard model was used for this study. Results: A total of 631 patients were included. The mean age was 71.8 +/- 6.1 y old (female: 53.6%). HVD was found in 259 patients (41%) during echocardiographic follow-up (mean 3.3 +/- 3.0 y). Patient-prosthetic mismatch was found in 174 patients. One hundred and twenty-six patients died during follow-up (median 62.1 mo, interquartile range 31.1-96.8). The development of HVD was an independent risk factor for death during follow-up (P = 0.038, hazard ratio 1.46, 95% confidential interval: 1.02-2.08). Conclusions: HVD was common after bioprosthetic SAVR during mid-term follow-up. Developing HVD, including moderate and severe grades, was associated with a poor sur-vival rate compared with patients without HVD. (c) 2022 Elsevier Inc. All reserved.

Automated summary

In patients undergoing surgical aortic valve replacement (SAVR), the development of hemodynamic valve deterioration (HVD) is a common concern. This study found that developing HVD was associated with a higher risk of death during follow-up.