Characteristics and longer-term outcomes of paravalvular leak after aortic and mitral valve surgery.

摘要: Abstract Background Paravalvular leak (PVL) is often seen after aortic (AV) and mitral valve (MV) surgery, either due to infection or dehiscence. We sought describe predictors of longer-term outcomes in patients who developed PVL AV MV surgery were considered eligible for reoperative cardiac (RCS). Methods studied 495 such (65 ± 14 years, 65% men, 47% with PVL) presented at our center between January 2003 December 2011. Patients severe mitral/aortic stenosis, less than mild PVL, those prohibitive risk precluding RCS excluded. Society Thoracic Surgeons (STS) score was calculated. Primary endpoint mortality. Results At baseline, mean STS left ventricular ejection fraction 5.8 ± 4% 52 ± 12%, respectively. In total, 105 (21%) had infective 72% moderate greater PVL. a median 8 days, 351 (71%) underwent repair (3% in-hospital postoperative mortality), 6.6 ± 4 years, 230 (47%) died. On multivariable Cox survival analysis, (hazard ratio HR 1.35), versus (HR 1.66), infectious etiology 2.05), right systolic pressure 1.09) associated mortality, whereas 0.58) improved (all P  Conclusions develop AV/MV have high rate despite excellent perioperative outcomes. Greater score, pressure, etiology, (vs AV) involvement all independently long-term closure survival.