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