Mortality and complications
The 30-days mortality in our study cohort was 1/38 patients (2.6%),
however in the follow-up we had other death due to mediastinitis (in the
second month after surgery). Mean follow-up was 19(±8.9) months and
survival rate was 94.7% (36/38) at this time. The largest series of
patients published by Ozaki et al. reports a hospital mortality of
16/850 (~1.9%) patients and a survival of 85% in a
mean follow-up of 53.7 (±28.2) months.20 Krane et al.
in a cohort of 103 patients reports a hospital mortality of 0.97%
(1/103 patients), the overall survival was 98.1% with a mean follow up
time of 426±270 days (range: 9–889 days). Iida et al. reports a
hospital mortality of 2/144 (1.4%) and an overall survival rates of
89.5 and 77.2% at 12 and 60 months, respectively. Oliver et al. reports
a hospital mortality of 1/30 patients (3.33%) which was maintained in a
3-month follow-up. Recently Ngo et al. in a series of 67 patients in
Vietnam, reports a 1.7% hospital mortality and a survival of
65/67(97%) patients at one year of follow-up. 21-23
The medium-term survival rate in our series is acceptable and comparable
with other published cohorts. We had two cases of mortality, the first
due to intraoperative coronary embolism in a 68-year-old patient with
severely calcified bicuspid AV, who died of circulatory complications
despite performing CABG. The other case of mortality occurred in a
75-year-old woman with morbid obesity (BMI=40) and diabetes mellitus who
presented severe symptomatic aortic stenosis. Initially, we had rejected
this case as a candidate for AVRec surgery, however, after discussing it
in the heart team, we were decided to submit the patient to surgery
because she had a 19mm aortic annulus, and the probability of mismatch
for AV replacement was high. Finally, this patient died to complications
due to mediastinitis in the second month after surgery.
In 26 patients under 65 years of age we did not have in-hospital
mortality, nor did we have it in the follow-up, 100% of the patients
remain alive. These excellent results have also been seen in other
series of the same age group.24,25