Systemic hypertension as a risk factor for complications with an aortic mechanical valve.

Abstract

We sought to determine the effect of preoperative systemic hypertension on prosthesis related complications or postoperative aortic dissection after valve replacement in patients with aortic regurgitation. The patients were divided into two groups according to the presence or absence of systemic hypertension: Group I, with hypertension (n = 35), and Group II, without hypertension (n = 37). The survival rate and event free rate were examined for 72 patients who were alive 30 days after valve replacement with a St. Jude Medical valve for aortic regurgitation. The cumulative 10 year survival rate of Group I (65% +/- 12%) was lower than that of Group II (79% +/- 15%). The 10 year event free rate of all prosthesis related complications was 62% +/- 13% in Group I, and 96% +/- 3% in Group II (p < 0.05). The 10 year event free rate for ascending aortic dissection was 73% +/- 12% in Group I and 100% in Group II (p < 0.05). The linearized event rate of all prosthesis related complication was 3.8% per patient-year in Group I and 0.5% per patient-year in Group II. In conclusion, systemic hypertension was a risk factor for prosthesis related complications and for complicated aortic lesions after aortic valve replacement. Careful postoperative management for hypertension is necessary in patients with systemic hypertension after aortic valve replacement. Tissue valves may be recommended in patients with aortic valve disease and severe hypertension.