Type of valvular heart disease requiring surgery in the 21st century: Mortality and length-of-stay related to surgery

Konstantinos Dean Boudoulas, Yazhini Ravi, Daniel Garcia, Uksha Saini, Gbemiga G. Sofowora, Richard J. Gumina, Chittoor B. Sai-Sudhakar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac procedures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.

Original languageEnglish (US)
Pages (from-to)104-109
Number of pages6
JournalOpen Cardiovascular Medicine Journal
Volume7
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Heart Valve Diseases
Length of Stay
Mortality
Hospital Mortality
Aortic Valve
Mitral Valve
Aortic Valve Stenosis
Mitral Valve Insufficiency
Coronary Artery Bypass
Mitral Valve Stenosis
Rheumatic Heart Disease
State Hospitals
Aortic Valve Insufficiency
Tertiary Healthcare
Quality Improvement
Tertiary Care Centers

Keywords

  • Aortic valve
  • Heart valve
  • Mitral valve
  • Outcomes
  • Surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Boudoulas, K. D., Ravi, Y., Garcia, D., Saini, U., Sofowora, G. G., Gumina, R. J., & Sai-Sudhakar, C. B. (2013). Type of valvular heart disease requiring surgery in the 21st century: Mortality and length-of-stay related to surgery. Open Cardiovascular Medicine Journal, 7(1), 104-109. https://doi.org/10.2174/1874192420130902001

Type of valvular heart disease requiring surgery in the 21st century : Mortality and length-of-stay related to surgery. / Boudoulas, Konstantinos Dean; Ravi, Yazhini; Garcia, Daniel; Saini, Uksha; Sofowora, Gbemiga G.; Gumina, Richard J.; Sai-Sudhakar, Chittoor B.

In: Open Cardiovascular Medicine Journal, Vol. 7, No. 1, 01.01.2013, p. 104-109.

Research output: Contribution to journalArticle

Boudoulas, Konstantinos Dean ; Ravi, Yazhini ; Garcia, Daniel ; Saini, Uksha ; Sofowora, Gbemiga G. ; Gumina, Richard J. ; Sai-Sudhakar, Chittoor B. / Type of valvular heart disease requiring surgery in the 21st century : Mortality and length-of-stay related to surgery. In: Open Cardiovascular Medicine Journal. 2013 ; Vol. 7, No. 1. pp. 104-109.
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abstract = "Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac procedures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5{\%} (replacement 3.4{\%}; repair 1.6{\%}), 3.9{\%}, 5.6{\%} and 5.8{\%}, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2{\%} (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.",
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AU - Saini, Uksha

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AU - Gumina, Richard J.

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AB - Aim: While the incidence of rheumatic heart disease has declined dramatically over the last half-century, the number of valve surgeries has not changed. This study was undertaken to define the most common type of valvular heart disease requiring surgery today, and determine in-hospital surgical mortality and length-of-stay (LOS) for isolated aortic or mitral valve surgery in a United States tertiary-care hospital. Methods: Patients with valve surgery between January 2002 to June 2008 at The Ohio State University Medical Center were studied. Patients only with isolated aortic or mitral valve surgery were analyzed. Results: From 915 patients undergoing at least aortic or mitral valve surgery, the majority had concomitant cardiac procedures mostly coronary artery bypass grafting (CABG); only 340 patients had isolated aortic (n=204) or mitral (n=136) valve surgery. In-hospital surgical mortality for mitral regurgitation (n=119), aortic stenosis (n=151), aortic insufficiency (n=53) and mitral stenosis (n=17) was 2.5% (replacement 3.4%; repair 1.6%), 3.9%, 5.6% and 5.8%, respectively (p=NS). Median LOS for aortic insufficiency, aortic stenosis, mitral regurgitation, and mitral stenosis was 7, 8, 9 (replacement 11.5; repair 7) and 11 days, respectively (p<0.05 for group). In-hospital surgical mortality for single valve surgery plus CABG was 10.2% (p<0.005 compared to single valve surgery). Conclusions: Aortic stenosis and mitral regurgitation are the most common valvular lesions requiring surgery today. Surgery for isolated aortic or mitral valve disease has low in-hospital mortality with modest LOS. Concomitant CABG with valve surgery increases mortality substantially. Hospital analysis is needed to monitor quality and stimulate improvement among Institutions.

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