Java AP, Greason KL, Dispenzieri A, Grogan M, King KS, Maleszewski JJ, Daly RC, Eleid MF, Pochettino A, Schaff HV. Aortic valve replacement in patients with amyloidosis.
J Thorac Cardiovasc Surg 2017;
156:98-103. [PMID:
29397971 DOI:
10.1016/j.jtcvs.2017.12.048]
[Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/06/2017] [Accepted: 12/04/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND
Outcome data on aortic valve replacement in patients with amyloidosis are limited. To address this issue, we reviewed our experience of patients with amyloidosis who underwent aortic valve replacement.
METHODS
We retrospectively reviewed the records of 16 patients with amyloidosis who underwent aortic valve replacement between May 2000 and February 2017.
RESULTS
The cohort comprised 11 males (69%) and 5 females (31%). The median patient age was 76 years (interquartile range [IQR], 71-82 years), and Society of Thoracic Surgeons predicted rate of mortality was 5.0% (IQR, 2.4%-8.7%). Amyloidosis type was immunoglobulin light chain in 6 patients (38%), age-related in 6 (38%), and localized in 4 (25%). The operation was surgical aortic valve replacement in 11 patients (69%) and balloon-expandable transfemoral transcatheter aortic valve insertion in the other 5. There was no procedure-related stroke, need for new-onset dialysis or pacemaker, or death within 30 days of surgery. The median length of hospital stay was 1 day (IQR, 1-2 days) in the transcatheter valve insertion group and 6 days (IQR, 6-8 days) in the surgical group (P = .002). Follow-up was available for all patients at a median of 1.9 years (IQR, 1.2-4.8 years). During the follow-up period, there were 4 deaths, all occurring >1 year after surgery.
CONCLUSIONS
Aortic valve replacement can be performed with low risk of operative morbidity and mortality in patients with amyloidosis. Transcatheter valve insertion has the advantage of reduced hospital length of stay. The 1-year survival is excellent.
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