Mid-Term Outcome after Aortic Valve Replacement in Tertiary hospital

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Sira Laohathai
Montien Ngodngamtaweesuk
Piya Samankatiwat


Background: Surgical aortic valve replacement (SAVR) is a standard procedure for symptomatic aortic valve disease, however, there was a limited data about this procedure in Thailand especially in terms of long-term outcomes. This study aims to present mid-term results after aortic valve replacement as a single institution.

Methods: A retrospective cohort study was conducted. All 112 consecutive patients who underwent isolated SAVR at Ramathibodi hospital between 2010 – 2015 were enrolled in this study. Patient characteristics, operative procedures, perioperative complications and postoperative outcomes were retrospectively reviewed from medical recording system. The endpoints were overall survival at 30 days, 1 years and 5 years, peri-operative and valve-related complications.

Results: There was 112 patients. Seventy-eight (69%) patients were male. Median age was 66 (IQR 14-87). Median follow-up period was 36 months (IQR 24-60). The most common pre-operative clinical symptoms were congestive heart failure followed by myocardial infarction and angina pectoris. The majority of pathology was degenerative aortic stenosis. Median of Euroscore was 1.5% (0.5-7%). Thirty-day, one-year and three-year survival of isolated SAVR was 98, 96 and 96 % respectively. There were 4.4 % of the patients who required a permanent pacemaker and stroke rate was 1.8%. In subgroup analysis, there was no difference in overall survival between age < 60 and more than 60 years old. (P=0.67)

Conclusion: An isolate aortic valve replacement is a safe procedure with a low post-operative complication and also demonstrate a good long-term outcome.


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Laohathai, S., Ngodngamtaweesuk, M., & Samankatiwat, P. (2020). Mid-Term Outcome after Aortic Valve Replacement in Tertiary hospital. Vajira Medical Journal : Journal of Urban Medicine, 64(6), 381–388. https://doi.org/10.14456/vmj.2020.37
Original Articles


Davies SW, Gershlick AH, Balcon R. Progression of valvar aortic stenosis: a long-term retrospective study. Eur Heart J 1991;12(1):10-4.

Horstkotte D, Loogen F. The natural history of aortic valve stenosis. Eur Heart J 1988;9 Suppl E:57-64.

Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Barwolf C, Levang OW, et al. A prospective survey of patients with valvular heart disease in Europe: The Euro Heart Survey on Valvular Heart Disease. Eur Heart J 2003;24(13):1231-43.

Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet.2006;368(9540):1005-11.

Ross J, Jr., Braunwald E. Aortic stenosis. Circulation. 1968;38(1 Suppl):61-7.

Baumgartner H. The 2017 ESC/EACTS guidelines on the management of valvular heart disease : What is new and what has changed compared to the 2012 guidelines? Wien Klin Wochenschr.2018;130(5-6):168-71.

Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, et al. [2014 ESC/EACTS Guidelines on myocardial revascularization]. Kardiol Pol. 2014;72(12):1253-379.

Ashikhmina EA, Schaff HV, Dearani JA, Sundt TM, 3rd, Suri RM, Park SJ, et al. Aortic valve replacement in the elderly: determinants of late outcome. Circulation 2011;124(9):1070-8.

Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. EuroSCORE II. Eur J Cardiothorac Surg 2012;41(4):734-44; discussion 44-5.

Smilowitz NR, Gupta N, Ramakrishna H, Guo Y, Berger JS, Bangalore S. Perioperative Major Adverse Cardiovascular and Cerebrovascular Events Associated With Noncardiac Surgery.JAMA Cardiol 2017;2(2):181-7.

Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, et al. Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med 2010;363(17):1597-607.

Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, et al. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med 2012;366(18):1696-704.

Mack MJ, Leon MB, Smith CR, Miller DC, Moses JW, Tuzcu EM, et al. 5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial. Lancet 2015;385(9986):2477-84.

Astor BC, Kaczmarek RG, Hefflin B, Daley WR. Mortality after aortic valve replacement: results from a nationally representative database. Ann Thorac Surg 2000;70(6):1939-45.

Clark RE. The STS Cardiac Surgery National Database: an update. Ann Thorac Surg.1995;59(6):1376-80; discussion 80-1.

Kvidal P, Bergstrom R, Malm T, Stahle E. Longterm follow-up of morbidity and mortality after aortic valve replacement with a mechanical valve prosthesis. Eur Heart J 2000;21(13):1099-111.