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Risk factors of morbidity and mortality in surgically treated chronic aortic valvular heart disease.

A cohort of 617 patients underwent aortic valve replacement (AVR) the median follow-up time was 3.4 years with a range (0-7.8) years. The incidence of early mortality was 5.0% and the five years survival (77.9 +/- 1.9)%. Risk factors of early mortality and morbidity (Low Output Syndrome) occurring the first 31 days after operation were pinpointed. Another analysis was done to estimate independent predictors of late premature death from all causes, and from specific causes (cardiac related, sudden cardiac). One of the major late morbid events was the appearance of systemic emboli. Its rate was 1.4% pats. Year. Its risk factors were presence of pure aortic regurgitation and advanced age at operation. The relative survival rate was at 5 years of 87.0% for the total cohort, but for our younger patients (age less than 30 years), we reached 99.4%. Our results suggest more aggressive measures to correct the hazard in AVR, and impose carefulness in comparing quality of AVR from different institutions for mortality and morbidity. Finally the results of AVR are rather palliative than curative except for our younger patients where we reached curability.