Determinants of operative mortality for XXXX undergoing aortic valve replacement. Discriminant analysis of 1,479 operations.

@entity1 @entity340 @entity8 @entity850 @entity951 @entity337 @entity955 @entity472 @entity884
The influence of 35 preoperative and intraoperative characteristics on operative mortality risk after 1,479 isolated aortic valve replacement procedures (1967 to 1981) was investigated utilizing univariate and multivariate logistic regression analyses. Mean age at operation was 58 +/- 13 years; 72% of @entity1 were @entity1 . Physiology was classified as @entity472 (58%), regurgitation (30%), or both (9%). The overall operative mortality rate was 7% +/- 1%, but there were substantial differences in operative mortality rates among physiological subgroups ( @entity337 , 10% +/- 2%; @entity472 , 6% +/- 1%; @entity850 /regurgitation, 5% +/- 2%). Independent determinants of operative mortality rate in the entire group were advanced New York Heart Association functional class, @entity8 , physiological subgroup, @entity955 , and older age. In the @entity337 subgroup, functional class, @entity955 , and operative year were independent predictors. In the @entity472 subgroup, the significant determinants were functional class, @entity8 , age, prosthetic @entity340 , and @entity951 . Concomitant coronary bypass grafting, previous operation, @entity884 , and ascending aortic replacement had no independent predictive effect on operative mortality rate. Thus, the early results of aortic valve replacement can be related to several specific variables describing the functional and physiological status of the @entity1 . Operative mortality rate is not independently related to previous operation or concomitant operative procedures. Specific differences in risk factors exist among the various physiological subgroups, probably reflecting the pathophysiology of the different hemodynamic lesions. This information should provide for a more rational approach to aortic valve replacement, at least in terms of early risk/benefit deliberations.
