Risk of stroke following valve replacement surgery

Caswell, J.; O'Brien, Bridget; Schneck, Michael

doi:10.1053/j.scds.2004.04.004

Cited by 5 publications

(4 citation statements)

References 32 publications

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“…3,41 The higher rate of stroke at the mitral position is attributed to an increased likelihood of atrial enlargement and perioperative atrial fi brillation. 42 Combined CABG, carotid endarterectomy, or concomitant repair of other cardiac abnormalities increases the perioperative stroke risk. Infective endocarditis following prosthetic heart valve surgery is associated with high morbidity and mortality.…”

Section: Cardiac Valve Surgerymentioning

confidence: 99%

Neurologic Complications of Cardiac Surgery and Interventional Cardiac Procedures

Biller

Hocker²,

Morales-Vidal³

2010

Hospital Practice

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Section: Cardiac Valve Surgerymentioning

confidence: 99%

Neurologic Complications of Cardiac Surgery and Interventional Cardiac Procedures

Biller

Hocker²,

Morales-Vidal³

2010

Hospital Practice

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“…Atrial brillation (AF) is a common cardiac arrhythmia among older adults [1], which is known to increase the risk of myocardial infarction, heart failure, stroke, dementia, and mortality [2]. Caswell et al [3] demonstrated that postoperative AF was a risk factor of cardioembolic stroke after valve replacement, and restoration of sinus rhythm is considered to be bene cial for improving long-term outcomes [4]. Surgery for AF has been shown to be feasible and effective, and does not increase perioperative morbidity and mortality when combined with other cardiac procedures [5] [6] [7].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: A comparative study with propensity score matching from a single-centre

Lin

Luo

et al. 2020

Preprint

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Background Concomitant bipolar radiofrequency ablation and valve replacement in the elderly remains controversial. In the current study, we aimed to compare the outcomes of concomitant valve replacement and bipolar radiofrequency ablation with valve replacement alone in elderly patients with atrial fibrillation (AF). Methods This was a retrospective study of patients aged ≥ 70 years who underwent valve replacement with or without bipolar radiofrequency ablation in a single-centre between January 2006 and March 2015. The early postoperative results and long-term clinical outcomes were compared after propensity score matching. Results A total of 34 pairs of patients (73.94 ± 2.64 years old; 34 in the AF with ablation group and 34 in the AF without ablation group) were enrolled in the propensity score matching analysis. There were no significant differences between the two matched groups in terms of surgical mortality (5.88% vs. 2.94%, P = 0.555) and major postoperative morbidity. Kaplan–Meier analysis revealed a significantly better overall survival in the AF with ablation group compared to the AF without ablation group (P = 0.009). Cumulative incidence curves showed a lower incidence of cardiovascular death in the AF with ablation group (P = 0.025, Gray’s test). Patients in the AF with ablation group had a reduced incidence of stroke compared to patients in the AF with ablation group (P = 0.009, Gray’s test). The freedom from AF after 5 years was 58.0% in the AF with ablation group and 3.0% in the AF without ablation group. Conclusions The addition of bipolar radiofrequency ablation is a safe and feasible procedure, even in patients aged ≥ 70 years, with a better long-term survival and a reduced incidence of stroke compared to valve replacement alone. These findings suggest that bipolar radiofrequency ablation should always be considered as a concomitant procedure for elderly patients with AF who require cardiac surgery. However, a large-scale, prospective, multi-centre, randomized study should be performed in the future to fully validate our findings.

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“…Atrial fibrillation (AF) is a common cardiac arrhythmia among older adults [ 1 ], which is known to increase the risk of myocardial infarction, heart failure, stroke, dementia, and mortality [ 2 ]. Caswell et al [ 3 ] demonstrated that postoperative AF was a risk factor of cardioembolic stroke after valve replacement, and restoration of sinus rhythm is considered to be beneficial for improving long-term outcomes [ 4 ]. Surgery for AF has been shown to be feasible and effective, and does not increase perioperative morbidity and mortality when combined with other cardiac procedures [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

Lin

Luo

et al. 2020

J Cardiothorac Surg

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Abstracts Background Concomitant bipolar radiofrequency ablation and valve replacement in the elderly remains controversial. In the current study, we aimed to compare the outcomes of concomitant valve replacement and bipolar radiofrequency ablation with valve replacement alone in elderly patients with atrial fibrillation (AF). Methods This was a retrospective study of patients aged ≥70 years who underwent valve replacement with or without bipolar radiofrequency ablation in a single-centre between January 2006 and March 2015. The early postoperative results and long-term clinical outcomes were compared after propensity score matching. Results A total of 34 pairs of patients (73.94 ± 2.64 years old; 34 in the AF with ablation group and 34 in the AF without ablation group) were enrolled in the propensity score matching analysis. There were no significant differences between the two matched groups in terms of surgical mortality (5.88% vs. 2.94%, P = 0.555) and major postoperative morbidity. Kaplan–Meier analysis revealed a significantly better overall survival in the AF with ablation group compared to the AF without ablation group (P = 0.009). Cumulative incidence curves showed a lower incidence of cardiovascular death in the AF with ablation group (P = 0.025, Gray’s test). Patients in the AF with ablation group had a reduced incidence of stroke compared to patients in the AF with ablation group (P = 0.009, Gray’s test). The freedom from AF after 5 years was 58.0% in the AF with ablation group and 3.0% in the AF without ablation group. Conclusions The addition of bipolar radiofrequency ablation is a safe and feasible procedure, even in patients aged ≥70 years, with a better long-term survival and a reduced incidence of stroke compared to valve replacement alone. These findings suggest that bipolar radiofrequency ablation should always be considered as a concomitant procedure for elderly patients with AF who require cardiac surgery. However, a large-scale, prospective, multi-centre, randomized study should be performed in the future to fully validate our findings.

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Risk of stroke following valve replacement surgery

Cited by 5 publications

References 32 publications

Neurologic Complications of Cardiac Surgery and Interventional Cardiac Procedures

Neurologic Complications of Cardiac Surgery and Interventional Cardiac Procedures

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: A comparative study with propensity score matching from a single-centre

Efficacy, safety, and long-term survival of concomitant valve replacement and bipolar radiofrequency ablation in patients aged 70 years and older: a comparative study with propensity score matching from a single-Centre

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