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**4** 

Wilhelm Mistiaen

*Belgium* 

**The 30 Day Complication Rate After Aortic** 

The stenotic degenerative aortic valve disease is a slowly developing condition. This condition is the result of an active process. Recently, it has been discovered that programmed cell death plays a major role in this progression (1-4). Stenotic degenerative aortic valve disease obstructs the outflow of the left ventricle (LV) and causes a pressure overload, with all its undesirable consequences. Once the disease has become symptomatic, the prognosis without surgical replacement of the valve is dismal: the life expectancy is reduced to 2 or 3 years with occurrence of syncope, angina pectoris and certainly with dyspnea (5). Age, left ventricular dysfunction and neurologic condition played a major role in the denial for AVR (6). Medical treatment and balloon valvotomy (7) do not improve the prognosis. Aortic valve replacement (AVR) is the only way to prolong life and improve its quality. In spite of technical improvements, the procedure involves a major procedure, with all its complications. Moreover, one condition (the valve disease) is replaced by another (the

The possible hospital or 30 day complications which can occur after AVR include valve related, cardiac non-valve related and non-cardiac events. Identification of their predictors could lead to an improved referral pattern and, hence to an improved 30 day outcome,

In one centre for cardiac surgery, 1000 patients who underwent AVR with Carpentier-Edwards cardiac valve, were studied in a retrospective way. The operations were performed between the end of 1986 and the end of 2006. In most patients with degenerative aortic valve disease, coronary artery disease was also present. Hence, patients who received concomitant CABG were also included. Their median age was 75 (71-77) years. The surgical technique remained largely unchanged and was performed through a median sternotomy. After opening the pericardium, the ascending aorta, the vena cava inferior and superior could be accessed for connection to the extracorporeal circulation. The pulmonary artery was ligated temporarily in a gentle way. A vent was placed through the left superior pulmonary vein in

**1. Introduction** 

prosthetic valve).

**2. Methods** 

provided these predictors are liable to changes.

**Valve Replacement with a Pericardial** 

**Valve in a Mainly Geriatric Population** 

*Artesis University College Antwerp, Dept of Healthcare Sciences and University of Antwerp, Faculty of Medicine, Antwerp* 

