PFO Closure in Cryptogenic Embolic Events, Wellington Registry 2008-2016

Abstract

they shouldwear out. Therefore we reviewed our experience with patients whose first two aortic valve replacements (AVR) were with bio-prosthetic valves. Methods: Patients receiving consecutive bio-prosthetic AVR performed by the Green Lane Cardiothoracic Surgical Unit were identified from a departmental database. Data retrieved from prospective databases, electronic and archived clinical records. Outcomes of interest were overall survival and freedom from third or more AVR. Results:267 patients met inclusion criteria with a mean follow up of 22.3 years. Concurrent procedures (CABG etc.) were performed in 65.2% of patients that underwent two bio-prosthetic AVR and 79.8% of patients undergoing three or more bio-prosthetic AVR. Mean survival of the cohort was 32.3 years. Age at operationwas the best predictor of needing a third or more AVR. ROC analysis identifies that being younger than 45 at first operation and 56 at second operation as the optimal cut-off point for likelihood of needing a third or more aortic valve intervention. Conclusion: Overall survival for consecutive bio-prosthetic AVR is remarkably good. Data on consecutive bioprosthetic AVR is of particular relevance to the evolution of TAVI and valve-in-valve TAVI. However it must be noted that the majority of patients in this cohort required concurrent cardiac surgical procedures. This study provides encouraging data for consecutive bio-prosthetic AVR and data that may be applicable in the setting TAVI being performed in younger cohorts of patients.