Categorical predictors were individually tested for equality of survival with the log-rank test. Patients were censored at the time of their last follow-up visit or at the time of death if the outcome of interest had not occurred. 18 The Kaplan–Meier method was used to generate survival curves. The relationship between short-term mortality and CBP time was analyzed using logistic regression modelling. Categorical variables are presented as frequencies (percentages) and compared between 2 age groups using the χ 2 test or Fisher exact test. Survival data are reported as means with standard errors or confidence intervals (CIs). The purpose of this study is to report the long-term outcome of SAVR in a series of patients in different age groups who were receiving dialysis, to identify independent risk factors predicting short-term mortality and reduced long-term survival and to evaluate the influence of cardiopulmonary bypass (CPB) pump time on outcomes.Ĭontinuous variables are reported as means with standard deviations (SDs) or medians with interquartile ranges and compared between 2 age groups using the Student t test or Wilcoxon rank sum test. There are limited data available on long-term outcomes following SAVR in patients with newer-generation bioprostheses who are receiving dialysis. 9 Furthermore, in the majority of those publications the bioprostheses were older-generation devices that are no longer being used. 8, 10 – 17 The largest study included 5858 patients receiving dialysis, but patients with mitral valve replacement alone were also included in the analysis and the follow-up time was relatively short (mean 18.8 mo). 8, 9Īlthough there is a substantial number of published studies on patients with SAVR who are receiving dialysis, most of these studies are retrospective with small sample sizes (19–108 patients). Surgical aortic valve replacement (SAVR) has been the standard treatment for symptomatic severe AS although surgical risk is relatively high in patients receiving dialysis. 5 – 7 In particular, calcific aortic stenosis (AS) is common in patients receiving long-term dialysis. 4 Patients receiving dialysis have a higher risk for the development of cardiovascular disease, heart failure and valve-related cardiac abnormalities, such as calcific cardiac valvular disease. 2, 3 Its prevalence is increasing most rapidy among patients aged 65 years and older. Renal disease requiring dialysis is a global public health problem 1 affecting more than more than 38 000 Canadians and more than 2 million people worldwide. Using alternative strategies to limit CPB pump time is an important way to reduce 30-day mortality. Older age (> 65 yr) is not an independent risk factor for either 30-day mortality or reduced long-term survival. Conclusion: Patients receiving dialysis have poor long-term survival with a very low rate of redo aortic valve surgery following SAVR with or without concomitant procedures.
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