Late incidence and determinants of stroke after aortic and mitral valve replacement

The Annals of Thoracic Surgery
Marc RuelThierry G Mesana

Abstract

Stroke is a devastating complication in patients with prosthetic valves, but characterization of its late occurrence from a large cohort is lacking. Three thousand one hundred eighty-nine adult patients who underwent a total of 3,576 operations for left-heart valve replacement were managed with contemporary anticoagulation guidelines and prospectively followed in a dedicated clinic. Total follow-up was 20,096 patient years. Bootstrapped survival analysis was used to determine the impact of patient and valve related factors on the incidence of stroke. Most strokes were embolic. Linearized embolic stroke rates were 1.3% +/- 0.2% per year for aortic bioprostheses, 1.4% +/- 0.2% per year for aortic mechanical valves, 1.3% +/- 0.3% per year for mitral bioprostheses, and 2.3% +/- 0.4% per year for mitral mechanical valves (p = 0.002, vs other implant types). Age more than 75 years, female gender, and smoking were independent risk factors after aortic and mitral valve replacement. Atrial fibrillation, coronary disease, and tilting-disc mechanical prostheses were independent predictors of embolic stroke after aortic valve replacement. Preoperative left ventricular (LV) dysfunction was an independent risk factor in patients with mitral ...Continue Reading

References

Aug 6, 1992·The New England Journal of Medicine·E J BenjaminD Levy
Sep 1, 1995·The Journal of Thoracic and Cardiovascular Surgery·R G MastersW J Keon
Jul 1, 1995·Stroke; a Journal of Cerebral Circulation·S K BraekkenJ Svennevig
Feb 1, 1995·The Annals of Thoracic Surgery·T A OrszulakG K Danielson
Mar 1, 1994·Journal of the American College of Cardiology·J HayashiS Eguchi
Jun 1, 1994·Annals of Internal Medicine·E M Hylek, D E Singer
Sep 21, 2000·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·A HassounaF Hassaballah
Feb 7, 2001·Chest·M N LevineC Kearon
Aug 2, 2001·American Journal of Epidemiology·S C Johnston
Jan 31, 2004·The Journal of Thoracic and Cardiovascular Surgery·Marc RuelThierry G Mesana
Jul 30, 2004·The Journal of Thoracic and Cardiovascular Surgery·Marc RuelThierry G Mesana

❮ Previous
Next ❯

Citations

Jan 8, 2013·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Thomas A SchwannRobert H Habib
Mar 1, 2010·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Davy C H ChengJohn D Puskas
Oct 28, 2005·Heart·B BridgewaterS Ray
Feb 5, 2011·The Journal of Thoracic and Cardiovascular Surgery·Munir BoodhwaniGebrine El Khoury
Aug 25, 2009·The Journal of Thoracic and Cardiovascular Surgery·Joel PriceMarc Ruel
Mar 5, 2009·The Journal of Thoracic and Cardiovascular Surgery·Elias BalarasJames S Gammie
Feb 3, 2009·The Journal of Thoracic and Cardiovascular Surgery·Munir BoodhwaniGébrine El Khoury
Nov 21, 2007·The Journal of Thoracic and Cardiovascular Surgery·Maciej BanachJan Henryk Goch
Aug 19, 2007·International Journal of Cardiology·Mehmet OzaydinErdogan Ibrisim
Jul 21, 2015·The Annals of Thoracic Surgery·Damien J LaParGorav Ailawadi
Oct 20, 2015·Breast Cancer Research and Treatment·Jianguang JiKristina Sundquist
Jul 30, 2010·The Annals of Thoracic Surgery·Giovanni FilardoPaul Grayburn
Aug 30, 2008·The Annals of Thoracic Surgery·Helmut GulbinsJuergen Ennker
Apr 25, 2006·The Annals of Thoracic Surgery·James S GammieBartley P Griffith
Jun 30, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·C M LawleyC L Roberts
May 21, 2015·Heart, Lung & Circulation·Andrew McLachlanAndrew Kerr
Nov 15, 2011·Journal of the American College of Cardiology·Benoit DaneaultMartin B Leon
Mar 22, 2008·Journal of the American College of Cardiology·Antonio RussoMaurice Enriquez-Sarano
May 11, 2007·Expert Review of Cardiovascular Therapy·Roel VinkMarcel Levi
Feb 27, 2017·Journal of Neurointerventional Surgery·Mary C ThomasYasha Kayan
Aug 7, 2007·Expert Review of Neurotherapeutics·Uma MenonRoger E Kelley
Nov 12, 2010·Hospital Practice·José BillerSarkis Morales-Vidal
Nov 21, 2020·American Heart Journal·Ashwin S NathanPeter W Groeneveld

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Related Papers

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Miguel ChaputMichel Pellerin
The Annals of Thoracic Surgery
L L CreswellJ L Cox
Journal of the American College of Cardiology
Rollo P VillarealAli Massumi
© 2022 Meta ULC. All rights reserved