Predictors of outcome in a multicenter port-access valve registry

被引:40
作者
Glower, DD
Siegel, LC
Frischmeyer, KJ
Galloway, AC
Ribakove, GH
Grossi, EA
Robinson, NB
Ryan, WH
Colvin, SB
机构
[1] Duke Univ, Med Ctr, Durham, NC 27710 USA
[2] Heartport Inc, Redwood City, CA USA
[3] NYU Med Ctr, New York, NY 10016 USA
[4] St Francis Hosp, Roslyn, NY USA
[5] Presbyterian Hosp, Dallas, TX USA
关键词
D O I
10.1016/S0003-4975(00)01748-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. The aim of this study was to examine the predictors of outcome in patients undergoing isolated valve operation using port-access techniques. Methods. Logistic regression analysis was performed in a prospective, multi-institutional registry of patients undergoing isolated aortic valve replacement (AVR, n = 252), mitral repair (MVP, n = 491), or mitral replacement (MVR, n = 568) using port-access techniques from 1997 to 1999. Results. Endoaortic balloon occlusion was used in 2% (AVR), 93% (MVP), and 90% (MVR) of cases. Conversion to full sternotomy occurred in 3.8% of all cases. For all patients, early mortality was 50 of 1,311 (3.8%) and onset of new atrial fibrillation occurred in 140 of 1,311 (11%) patients. The determinants of 30-day mortality were redo, age, and MVR or AVR. The determinants of reoperation for bleeding were age, reoperation, and MVR. Age was a predictor for stroke, and age and low or medium volume center were predictors of new atrial fibrillation. Conclusions. Excellent short-term results can be obtained using port-access techniques in isolated mitral or aortic valve operations. Patient outcome is not related to institutional case volume, and the primary determinants of outcome after port-access valve procedures are generally patient-related factors. (Ann Thorac Surg 2000;70:1054-9) (C) 2000 by The Society of Thoracic Surgeons.
引用
收藏
页码:1054 / 1059
页数:6
相关论文
共 23 条
[1]  
[Anonymous], 2007, Biostatistical analysis
[2]   (con) re minimally invasive port-access mitral valve surgery [J].
Baldwin, JC .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1998, 115 (03) :563-564
[3]  
BENNETTI FJ, 1997, J THORAC CARDIOVASC, V113, P806
[4]   Video-assisted minimally invasive mitral valve surgery [J].
Chitwood, WR ;
Wixon, CL ;
Elbeery, JR ;
Moran, JF ;
Chapman, WHH ;
Lust, RM .
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY, 1997, 114 (05) :773-780
[5]  
Cohn L H, 1997, Semin Thorac Cardiovasc Surg, V9, P331
[6]   Port-Access™ mitral valve surgery:: Summary of results [J].
Colvin, SB ;
Galloway, AC ;
Ribakove, G ;
Grossi, EA ;
Zakow, P ;
Buttenheim, PM ;
Baumann, FG .
JOURNAL OF CARDIAC SURGERY, 1998, 13 (04) :286-289
[7]  
Fann J I, 1997, Semin Thorac Cardiovasc Surg, V9, P320
[8]   First report of the Port Access International Registry [J].
Galloway, AC ;
Shemin, RJ ;
Glower, DD ;
Boyer, JH ;
Groh, MA ;
Kuntz, RE ;
Burdon, TA ;
Ribakove, GH ;
Reitz, BA ;
Colvin, SB .
ANNALS OF THORACIC SURGERY, 1999, 67 (01) :51-56
[9]  
Galloway AC, 1997, CIRCULATION, P508
[10]   Comparison of direct aortic and femoral cannulation for port-access cardiac operations [J].
Glower, DD ;
Clements, FM ;
Debruijn, NP ;
Staford-Smith, M ;
Davis, RD ;
Landolfo, KP ;
Smith, PK .
ANNALS OF THORACIC SURGERY, 1999, 68 (04) :1529-1531