ES Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre.

Executive Summary

Surgical aortic valve replacement etiologies, hemodynamics, and outcomes in 1346 patients from the Malaysian heart centre

Aslannif Roslan

Aslannif Roslan, Chong Kee Soon, Tey Yee Sin, Ahmad Tantawi Jauhari Aktifanus, Soh Si Ling, Wong Kian Boon, Beni I. Rusani, Hafidz Abd Hadi, Jayakhanthan Kolanthaivelu, Shaiful Azmi Yahaya, Jeswant Dillon and Alwi M. Yunus.

Published: J Cardiothorac Surg. 2 Jan 2024;19:3

Background

This study looked at people in Malaysia who had surgery to replace their aortic valve, an important valve in the heart that helps blood flow out to the rest of the body. It covered surgeries done between 2015 and 2021 and included 1,346 patients. The goal was to find out why these patients needed the surgery, how their heart problems affected them, and what happened after the surgery.

Key Findings:

Common Conditions

  • The most frequent reason for the surgery was a condition called aortic stenosis (AS), which happens when the heart valve becomes too narrow. This makes it hard for blood to flow out of the heart. About 34.6% of the patients had severe AS. The second most common issue was aortic regurgitation (AR), which occurs when the valve doesn’t close properly, letting blood leak backward into the heart. This affected 25.5% of the patients.

 

Causes

  • AS was mainly caused by age-related wear and tear on the valve or from a condition present at birth, like having a bicuspid valve (with two flaps instead of three). AR was often linked to the enlargement of the area around the valve or infections such as endocarditis, which is an infection of the heart lining.

 

Outcomes

  • About 79.5% of the patients were still alive five years after their surgery. However, survival was slightly lower in those with severe AS compared to those with AR. During their hospital stay, 6.4% of the patients died, and within one year after surgery, the death rate rose to 14.8%.

 

Conclusion

This study shows that valve problems like aortic stenosis and regurgitation are serious health issues in Malaysia, with many cases linked to conditions like rheumatic heart disease. These findings underline the importance of early diagnosis and treatment, which can improve survival and help patients live longer, healthier lives after surgery.