Aortic stenosis surgery prognosis: Difference between revisions

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{{Aortic stenosis surgery}}
{{Aortic stenosis surgery}}


{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@perfuse.org]
{{CMG}}; '''Associate Editor-In-Chief:''' [[User:Mohammed Sbeih|Mohammed A. Sbeih, M.D.]] [mailto:msbeih@wikidoc.org]; {{USAMA}}
 
==Overview==
Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed.
The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute.<ref name="pmid27296201">{{cite journal| author=Dauerman HL, Reardon MJ, Popma JJ, Little SH, Cavalcante JL, Adams DH et al.| title=Early Recovery of Left Ventricular Systolic Function After CoreValve Transcatheter Aortic Valve Replacement. | journal=Circ Cardiovasc Interv | year= 2016 | volume= 9 | issue= 6 | pages=  | pmid=27296201 | doi=10.1161/CIRCINTERVENTIONS.115.003425 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27296201  }} </ref>


==Surgical Outcome==
==Surgical Outcome==
Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed.
Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed.
The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute. The patient's past history of heart surgery affects the mortality rate as well.
The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute. The patient's past history of heart surgery affects the mortality rate as well. Patients with decreased (less than 40%) preoperative LVEF undergoing transcatheter aortic valve replacement showed an early LVEF recovery after surgery.<ref name="pmid27296201">{{cite journal| author=Dauerman HL, Reardon MJ, Popma JJ, Little SH, Cavalcante JL, Adams DH et al.| title=Early Recovery of Left Ventricular Systolic Function After CoreValve Transcatheter Aortic Valve Replacement. | journal=Circ Cardiovasc Interv | year= 2016 | volume= 9 | issue= 6 | pages=  | pmid=27296201 | doi=10.1161/CIRCINTERVENTIONS.115.003425 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27296201  }} </ref>Patient with mechanical valve may hear a quiet clicking sound in his chest. This is just the sound of the new valve opening and closing, and a sign that the new valve is working.
Patient with mechanical valve may hear a quiet clicking sound in his chest. This is just the sound of the new valve opening and closing, and a sign that the new valve is working.


'''Mechanical Versus Biological Valves'''
====Mechanical Versus Biological Valves====


Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare.
[[Biological]] valves tend to fail over time <ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464  }} </ref>, but they have a lower risk of blood clots. Patients with a biological valve may need to have the valve replaced in 10 to 15 years. Patients with a mechanical valve will need to take a blood-thinning medicine for the rest of their lives.
[[Biological]] valves tend to fail over time, <ref name="pmid8469251">{{cite journal| author=Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S| title=A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease. | journal=N Engl J Med | year= 1993 | volume= 328 | issue= 18 | pages= 1289-96 | pmid=8469251 | doi=10.1056/NEJM199305063281801 | pmc= | url= }} </ref><ref name="pmid11028464">{{cite journal| author=Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH| title=Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. | journal=J Am Coll Cardiol | year= 2000 | volume= 36 | issue= 4 | pages= 1152-8 | pmid=11028464 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11028464  }} </ref> but they have a lower risk of blood clots. Patients with a biological valve may need to have the valve replaced in 10 to 15 years. Patients with a mechanical valve will need to take a blood-thinning medicine for the rest of their lives.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}
[[CME Category::Cardiology]]


[[Category:Disease]]
[[Category:Disease]]
[[Category:Signs and symptoms]]
[[Category:Physical Examination]]
[[Category:Valvular heart disease]]
[[Category:Valvular heart disease]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Congenital heart disease]]
[[Category:Congenital heart disease]]
[[Category:Mature chapter]]
[[Category:Cardiac surgery]]
[[Category:Cardiac surgery]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Overview complete]]
[[Category:Needs overview]]
[[Category:For review]]
[[Category:Template complete]]
 
{{WH}}
{{WS}}

Latest revision as of 16:00, 5 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Mohammed A. Sbeih, M.D. [2]; Usama Talib, BSc, MD [3]

Overview

Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed. The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute.[1]

Surgical Outcome

Most valve surgery operations are successful. In some rare cases, a valve repair may fail and another operation may be needed. The risk of death or serious complications from isolated aortic valve replacement is typically quoted as being between 1-3% of cases, depending on the health and age of the patient, as well as the skill of the surgeon and the health care institute. The patient's past history of heart surgery affects the mortality rate as well. Patients with decreased (less than 40%) preoperative LVEF undergoing transcatheter aortic valve replacement showed an early LVEF recovery after surgery.[1]Patient with mechanical valve may hear a quiet clicking sound in his chest. This is just the sound of the new valve opening and closing, and a sign that the new valve is working.

Mechanical Versus Biological Valves

Mechanical heart valves do not fail often. They last from 12 to 20 years. However, blood clots develop on them. If a blood clot forms, the patient may have a stroke. Bleeding can occur, but this is rare. Biological valves tend to fail over time, [2][3] but they have a lower risk of blood clots. Patients with a biological valve may need to have the valve replaced in 10 to 15 years. Patients with a mechanical valve will need to take a blood-thinning medicine for the rest of their lives.

References

  1. 1.0 1.1 Dauerman HL, Reardon MJ, Popma JJ, Little SH, Cavalcante JL, Adams DH; et al. (2016). "Early Recovery of Left Ventricular Systolic Function After CoreValve Transcatheter Aortic Valve Replacement". Circ Cardiovasc Interv. 9 (6). doi:10.1161/CIRCINTERVENTIONS.115.003425. PMID 27296201.
  2. Hammermeister KE, Sethi GK, Henderson WG, Oprian C, Kim T, Rahimtoola S (1993). "A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis. Veterans Affairs Cooperative Study on Valvular Heart Disease". N Engl J Med. 328 (18): 1289–96. doi:10.1056/NEJM199305063281801. PMID 8469251.
  3. Hammermeister K, Sethi GK, Henderson WG, Grover FL, Oprian C, Rahimtoola SH (2000). "Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial". J Am Coll Cardiol. 36 (4): 1152–8. PMID 11028464.

Template:WH Template:WS CME Category::Cardiology