Mortality and Worsening of Prognostic Profile During Waiting Time for Valve Replacement in Aortic Stenosis

• DOI: 10.1055/s-2007-1012039
• Publication Date: 2008-11-07T13:31:07Z
• Authors: O. Lund; T. Nielsen; K. Emmertsen; C. Flø; B. Rasmussen; F. Jensen; H. Pilegaard; L. Kristensen; O. Hansen
• Keywords: Mass index

In a prospective study 99 consecutive patients with operative indication due to severe aortic stenosis (AS) were put on surgical waiting list. The waiting-time valve replacement (AVR) averaged 6.3 months (0.5-19 months). There 58 men and 41 women mean age of 61 years (21-82 years). divided into three groups: group I (n = 81) an uneventful stay the list (including one patient who declined AVR offer); II 11) significant worsening prognostic index; III 7) died during waiting-time. waiting-list death rate was 13.5 +/- 5.0% patient-year-1 compared post-AVR 4.9 0.9%. (p < 0.05) follow-up 5.7 years. According their index at inclusion, had predicted (by Cox model) 7-year survival probability 72%, but only 61% according immediately preoperatively; observed 60%. Logistic regression analysis identified high age, short duration symptoms, hypertrophy strain in ECG, female sex, deranged left-ventricular diastolic function (related severely increased muscle mass) as independent predictors prognosis worsening. From clinical viewpoint, predictive models did not allow sufficiently accurate identification risk consequences averaging 6 are serious for AS patients. is subgroup worsen profile, significantly reduced long-term result.