Morbimortalidad precoz y alejada del reemplazo valvular aórtico con prótesis mecánica y biológica durante la última década: El estándar de oro

• Pedro Becker ^[1] ; Alejandro Ramírez ^[1] ; Ignacio Cifuentes ^[1] ; Rolando Rebolledo ^[1] ; Ricardo Zalaquett ^[1] ; Sergio Morán ^[1] ; Claudio Arretz ^[1] ; Iván Godoy ^[1] ; Manuel José Irarrázaval ^[1]
  1. [1] Pontificia Universidad Católica de Chile

     Pontificia Universidad Católica de Chile

     Santiago, Chile

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 137, Nº. 9, 2009, págs. 1153-1162
• Idioma: español
• Títulos paralelos:
  • Early and late morbidity and mortality of aortic valve replacement with mechanical or biological prostheses during the last decade: The gold standard
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• Resumen

  • Background: There is a growing interest in alternative techniques for aortic valve replacement (AVR). Therefore it is important to have updated results of conventional AYR as a valid comparative standard. Aim: To evaluate both perioperative and ¡ate morbidity and mortality in patients undergoing conventional AVR, with either mechanical (RVAm) or biological (RVAb) prostheses. Patients and methods: Retrospective review of medical records and operative protocols of patients undergoing AVR between January 1995 and December 2005. Patients with previous cardiac surgery, aortic balloonplasty or simultaneous cardiovascular procedures were excluded. Results: During the study period, 788 patients underwent AVR and 317 met the inclusion criteria. Of the latter, 175patients aged 13 to 83years (63% males) were subjected to AVRm and 142patients aged 49 to 87 years (64% males), were subjected to AVRb. Five (1.6%) patients died during the perioperative period (one AVRm and four AVRb). All were older than 65years. Perioperative complications were recorded in 29 and 25% of patients in AVRm and AVRb groups, respectively (NS). During a median follow-up of six years, complications were recorded in 12 and 4% of patients in AVRm and AVRb groups, respectively (p <0.05). The actuarial survival for AVRm group at 1, 5 and 10years, was 96, 92 and 87%, respectively. The figures for AVRb group were 95, 86 and 83%, respectively (NS). The 10 year reintervention free survival was 97% for the AVRm group and 84% for the AVRb (p <0.05). Conclusions: Perioperative mortality and rates of complications of AVR in this series of patients are low, which compares favorably with other series (Rev Méd Chile 2009; 137:1153-62).