National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery

Hassaan Bin Arshad; Abdul Mannan Khan Minhas; Safi U. Khan; Khurram Nasir; Neha Rao; Sameer Thacker; Sara Ayaz Butt; Nadeen Faza; Stephen H. Little; Moritz Wyler von Ballmoos; Neal S. Kleiman; Michael J. Reardon; Samir R. Kapadia; Sachin S. Goel

doi:10.1016/j.carrev.2021.11.016

National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery

Hassaan Bin Arshad, Abdul Mannan Khan Minhas, Safi U. Khan, Khurram Nasir, Neha Rao, Sameer Thacker, Sara Ayaz Butt, Nadeen Faza, Stephen H. Little, Moritz Wyler von Ballmoos, Neal S. Kleiman, Michael J. Reardon, Samir R. Kapadia, Sachin S. Goel

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

BACKGROUND: Incidence of multivalvular heart disease is increasing, with aortic stenosis and mitral regurgitation being the most common. Data are limited on outcomes of patients undergoing multivalvular surgery. The purpose of this study was to evaluate contemporary trends and in-hospital outcomes for combined surgical aortic valve replacement (SAVR) and mitral valve repair (MVr) or replacement (MVR).

METHODS: We identified patient hospitalizations aged ≥18 years who underwent SAVR + MVr or MVR between 2004 and 2018 using the National Inpatient Sample. Data were weighted to estimate national estimates of the entire US hospitalized population. Exclusion criteria included endocarditis, history of heart transplant or left ventricular assist device, and any other concomitant valve surgery.

RESULTS: Between January 1, 2004, and December 31, 2018, there were 68,882 weighted admissions for SAVR with concomitant mitral valve surgery. Overall, in-hospital mortality was 8.34% with significantly higher inpatient mortality in SAVR + MVR group compared with SAVR + MVr group (9.91% vs 5.57%, p < 0.001). During the study period, adjusted in-hospital mortality decreased in both SAVR + MVr group (p-trend 0.004) and SAVR + MVR group (p-trend <0.001). Age ≥70 years was associated with higher in-hospital mortality compared to those < 70 years (9.95% vs 6.70%, p < 0.001).

CONCLUSION: Combined aortic and mitral valve surgery is associated with a high risk of in-hospital mortality, especially in patients ≥ 70 years of age. Further research is needed to assess the role of transcatheter approaches in the treatment of multivalvular heart disease.

Original language	English (US)
Pages (from-to)	13-19
Number of pages	7
Journal	Cardiovascular Revascularization Medicine
Volume	40
DOIs	https://doi.org/10.1016/j.carrev.2021.11.016
State	Published - Jul 2022

Keywords

Adolescent
Adult
Aged
Aortic Valve/diagnostic imaging
Aortic Valve Stenosis/diagnostic imaging
Heart Valve Prosthesis Implantation
Hospital Mortality
Humans
Mitral Valve/diagnostic imaging
Risk Factors
Transcatheter Aortic Valve Replacement/adverse effects
Treatment Outcome

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.carrev.2021.11.016

Cite this

Arshad, H. B., Minhas, A. M. K., Khan, S. U., Nasir, K., Rao, N., Thacker, S., Butt, S. A., Faza, N., Little, S. H., von Ballmoos, M. W., Kleiman, N. S., Reardon, M. J., Kapadia, S. R., & Goel, S. S. (2022). National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery. Cardiovascular Revascularization Medicine, 40, 13-19. https://doi.org/10.1016/j.carrev.2021.11.016

Arshad, HB, Minhas, AMK, Khan, SU, Nasir, K, Rao, N, Thacker, S, Butt, SA, Faza, N , Little, SH, von Ballmoos, MW, Kleiman, NS , Reardon, MJ, Kapadia, SR & Goel, SS 2022, 'National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery', Cardiovascular Revascularization Medicine, vol. 40, pp. 13-19. https://doi.org/10.1016/j.carrev.2021.11.016

@article{40476f50dfc345909bf293d158d9a76a,

title = "National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery",

abstract = "BACKGROUND: Incidence of multivalvular heart disease is increasing, with aortic stenosis and mitral regurgitation being the most common. Data are limited on outcomes of patients undergoing multivalvular surgery. The purpose of this study was to evaluate contemporary trends and in-hospital outcomes for combined surgical aortic valve replacement (SAVR) and mitral valve repair (MVr) or replacement (MVR).METHODS: We identified patient hospitalizations aged ≥18 years who underwent SAVR + MVr or MVR between 2004 and 2018 using the National Inpatient Sample. Data were weighted to estimate national estimates of the entire US hospitalized population. Exclusion criteria included endocarditis, history of heart transplant or left ventricular assist device, and any other concomitant valve surgery.RESULTS: Between January 1, 2004, and December 31, 2018, there were 68,882 weighted admissions for SAVR with concomitant mitral valve surgery. Overall, in-hospital mortality was 8.34% with significantly higher inpatient mortality in SAVR + MVR group compared with SAVR + MVr group (9.91% vs 5.57%, p < 0.001). During the study period, adjusted in-hospital mortality decreased in both SAVR + MVr group (p-trend 0.004) and SAVR + MVR group (p-trend <0.001). Age ≥70 years was associated with higher in-hospital mortality compared to those < 70 years (9.95% vs 6.70%, p < 0.001).CONCLUSION: Combined aortic and mitral valve surgery is associated with a high risk of in-hospital mortality, especially in patients ≥ 70 years of age. Further research is needed to assess the role of transcatheter approaches in the treatment of multivalvular heart disease.",

keywords = "Adolescent, Adult, Aged, Aortic Valve/diagnostic imaging, Aortic Valve Stenosis/diagnostic imaging, Heart Valve Prosthesis Implantation, Hospital Mortality, Humans, Mitral Valve/diagnostic imaging, Risk Factors, Transcatheter Aortic Valve Replacement/adverse effects, Treatment Outcome",

author = "Arshad, {Hassaan Bin} and Minhas, {Abdul Mannan Khan} and Khan, {Safi U.} and Khurram Nasir and Neha Rao and Sameer Thacker and Butt, {Sara Ayaz} and Nadeen Faza and Little, {Stephen H.} and {von Ballmoos}, {Moritz Wyler} and Kleiman, {Neal S.} and Reardon, {Michael J.} and Kapadia, {Samir R.} and Goel, {Sachin S.}",

year = "2022",

month = jul,

doi = "10.1016/j.carrev.2021.11.016",

language = "English (US)",

volume = "40",

pages = "13--19",

journal = "Cardiovascular Revascularization Medicine",

issn = "1553-8389",

publisher = "Elsevier",

}

TY - JOUR

T1 - National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery

AU - Arshad, Hassaan Bin

AU - Minhas, Abdul Mannan Khan

AU - Khan, Safi U.

AU - Nasir, Khurram

AU - Rao, Neha

AU - Thacker, Sameer

AU - Butt, Sara Ayaz

AU - Faza, Nadeen

AU - Little, Stephen H.

AU - von Ballmoos, Moritz Wyler

AU - Kleiman, Neal S.

AU - Reardon, Michael J.

AU - Kapadia, Samir R.

AU - Goel, Sachin S.

PY - 2022/7

Y1 - 2022/7

N2 - BACKGROUND: Incidence of multivalvular heart disease is increasing, with aortic stenosis and mitral regurgitation being the most common. Data are limited on outcomes of patients undergoing multivalvular surgery. The purpose of this study was to evaluate contemporary trends and in-hospital outcomes for combined surgical aortic valve replacement (SAVR) and mitral valve repair (MVr) or replacement (MVR).METHODS: We identified patient hospitalizations aged ≥18 years who underwent SAVR + MVr or MVR between 2004 and 2018 using the National Inpatient Sample. Data were weighted to estimate national estimates of the entire US hospitalized population. Exclusion criteria included endocarditis, history of heart transplant or left ventricular assist device, and any other concomitant valve surgery.RESULTS: Between January 1, 2004, and December 31, 2018, there were 68,882 weighted admissions for SAVR with concomitant mitral valve surgery. Overall, in-hospital mortality was 8.34% with significantly higher inpatient mortality in SAVR + MVR group compared with SAVR + MVr group (9.91% vs 5.57%, p < 0.001). During the study period, adjusted in-hospital mortality decreased in both SAVR + MVr group (p-trend 0.004) and SAVR + MVR group (p-trend <0.001). Age ≥70 years was associated with higher in-hospital mortality compared to those < 70 years (9.95% vs 6.70%, p < 0.001).CONCLUSION: Combined aortic and mitral valve surgery is associated with a high risk of in-hospital mortality, especially in patients ≥ 70 years of age. Further research is needed to assess the role of transcatheter approaches in the treatment of multivalvular heart disease.

AB - BACKGROUND: Incidence of multivalvular heart disease is increasing, with aortic stenosis and mitral regurgitation being the most common. Data are limited on outcomes of patients undergoing multivalvular surgery. The purpose of this study was to evaluate contemporary trends and in-hospital outcomes for combined surgical aortic valve replacement (SAVR) and mitral valve repair (MVr) or replacement (MVR).METHODS: We identified patient hospitalizations aged ≥18 years who underwent SAVR + MVr or MVR between 2004 and 2018 using the National Inpatient Sample. Data were weighted to estimate national estimates of the entire US hospitalized population. Exclusion criteria included endocarditis, history of heart transplant or left ventricular assist device, and any other concomitant valve surgery.RESULTS: Between January 1, 2004, and December 31, 2018, there were 68,882 weighted admissions for SAVR with concomitant mitral valve surgery. Overall, in-hospital mortality was 8.34% with significantly higher inpatient mortality in SAVR + MVR group compared with SAVR + MVr group (9.91% vs 5.57%, p < 0.001). During the study period, adjusted in-hospital mortality decreased in both SAVR + MVr group (p-trend 0.004) and SAVR + MVR group (p-trend <0.001). Age ≥70 years was associated with higher in-hospital mortality compared to those < 70 years (9.95% vs 6.70%, p < 0.001).CONCLUSION: Combined aortic and mitral valve surgery is associated with a high risk of in-hospital mortality, especially in patients ≥ 70 years of age. Further research is needed to assess the role of transcatheter approaches in the treatment of multivalvular heart disease.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aortic Valve/diagnostic imaging

KW - Aortic Valve Stenosis/diagnostic imaging

KW - Heart Valve Prosthesis Implantation

KW - Hospital Mortality

KW - Humans

KW - Mitral Valve/diagnostic imaging

KW - Risk Factors

KW - Transcatheter Aortic Valve Replacement/adverse effects

KW - Treatment Outcome

UR - http://www.scopus.com/inward/record.url?scp=85119363257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85119363257&partnerID=8YFLogxK

U2 - 10.1016/j.carrev.2021.11.016

DO - 10.1016/j.carrev.2021.11.016

M3 - Article

C2 - 34801422

AN - SCOPUS:85119363257

SN - 1553-8389

VL - 40

SP - 13

EP - 19

JO - Cardiovascular Revascularization Medicine

JF - Cardiovascular Revascularization Medicine

ER -

National Trends and Outcomes of Surgical Aortic Valve Replacement With Concomitant Mitral Valve Surgery

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