Risk factors for XXXX and the degeneration of pericardial valves after aortic valve replacement.

@entity1 @entity712 @entity6 @entity886 @entity472 @entity412 @entity731 @entity340 @entity165
BACKGROUND: Recent studies have demonstrated the influence of atherosclerotic risk factors on the progression of @entity472 . We hypothesized that risk factors for @entity731 might also be involved in the @entity340 and might lead to reoperation as a result of @entity712 , especially in younger @entity1 with high degeneration rates. METHODS: In 1984 and 1985, 161 @entity1 (74% male; mean age, 54.4 +/- 1.0 years; age range, 17-76 years; median age, 56.5 years) survived isolated aortic (n = 137) or combined aortic and mitral (n = 25) valve replacement with a Hancock extracorporeal pericardial valve. Of these @entity1 , 90 (56%) had reoperations as a result of tissue failure of the aortic valve 5.6 +/- 0.25 years postoperatively. RESULTS: The @entity1 group was split in half at the median age. In @entity1 aged 57 years or younger, @entity6 , female sex, cigarette smoking, and high @entity165 and @entity412 levels were associated with accelerated valve failure. In a multivariate model sex (female, P =.001), smoking (P =.001), @entity6 (P =.020), and @entity165 levels (P =.011) are risk factors for reoperation. @entity1 without risk factors had reoperation after a mean of 9.25 +/- 0.88 years compared with 4.05 +/- 0.43 years (P =.0002) in @entity1 with 2 or 3 risk factors. CONCLUSIONS: Risk factors of @entity731 might play a substantial role in the @entity886 . Lowering of serum lipid levels, smoking cessation, therapy for @entity6 , and careful @entity1 selection could be new strategies to postpone degeneration. Younger @entity1 could then possibly benefit from the advantages of bioprostheses.
