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J Thorac Cardiovasc Surg 2007;133:1020-1021
© 2007 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Discussion

The first 20% of the full text of this article appears below.

Dr George T. Christakis (Toronto, Canada). The authors are to be congratulated for this work, which adds substantially to the knowledge base of aortic valvular prosthesis size and its purported influence on operative mortality. The authors have used contemporary data from a homogenous population undergoing aortic valve replacement. The cohort is large with good statistical predictive power. Dr. Bridges and his colleagues performed multivariable analyses and demonstrated that effective orifice area or indexed effective orifice area, but not both, were independent predictors of operative mortality following aortic valve replacement.

We in Toronto have previously published data confirming an increase in operative mortality following aortic valve replacement when the indexed effective orifice area is less than 0.6 cm2/m2. We demonstrated operative mortalities of 2.1% versus less than 1% depending on whether they were above or below 0.6 cm2/m2. We also demonstrated that an indexed effective orifice area less than 0.6 cm2/m2 represented the 10th percentile for patient prosthesis size. This is, coincidentally, the exact cutoff Dr Bridges and colleagues have used to represent the lowest indexed effective orifice area.

In . . . [Full Text of this Article]


Related Article

Association between indices of prosthesis internal orifice size and operative mortality after isolated aortic valve replacement
Charles R. Bridges, Sean M. O’Brien, Joseph C. Cleveland, Edward B. Savage, James S. Gammie, Fred H. Edwards, Eric D. Peterson, and Frederick L. Grover
J. Thorac. Cardiovasc. Surg. 2007 133: 1012-1021. [Abstract] [Full Text] [PDF]





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