Statistics on AVR operations

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don6170

Member
Joined
Feb 25, 2014
Messages
17
Location
NC - USA
Is there a good source for statistics and information on AVR surgery? The numbers I have seen are 60-80,000 operations per year, with ~1% fatality rate. I have significant stenosis as a result of radiation for Hodgkin’s, which I have been told makes thing much more complicated. (This is one time I don’t want to be a one-percenter:)).

I will be having the operation at a top-ten hospital and the surgeon is highly recommended, so that helps with some of the stress.
 
JACC: Prediction of operative mortality after valve replacement surgery

JACC: Prediction of operative mortality after valve replacement surgery

If you would like to wallow in statistics, you should read through this paper published in the "Journal of the American College of Cardiology", 03 March, 2001. You can read the abstract which contains the tables in the conclusion or if you wish, you can purchase a copy of the paper.

http://content.onlinejacc.org/article.aspx?articleid=1127024

I suspect that most of our surgeons are relying on this paper when they tell us that if we are otherwise healthy and are not in need of a more complex surgery that our risk of mortality is 1%. Actually, its probably less than that if one is otherwise healthy if I understand the graphs correctly. Just as expected, they indicate the more procedures that must be completed during surgery increases risk just as does other serious health problems unrelated to one's heart problem. Enjoy the tables.

Larry
 
The other thing that my surgeon reminded me about is that although the published statistics show something like about a 1% mortality rate, your mileage may vary. Those stats include a large sample of patients, including some who were very sick and some who were very old. My surgeon felt that I should consider my mortality rate to be about 1/2% because I was not "old" at 63 and was otherwise healthy.

I think that you will be in the "1% or less" category, since you are seeing a top-rated surgeon and he is fully aware of your prior health situation. I'm not a doctor, but I've been around here and reading it all for years.

P.S. "1% or less" is probably a better likelihood of success than that of many other common surgical procedures.
 
P.S. "1% or less" is probably a better likelihood of success than that of many other common surgical procedures.

My docs also told me that this surgery was easier than many others of the time.....although the mortality risk was a little higher, about 6%, back then. However, it was much lower than my risk of "sudden death", about 25%, without warning, according to the docs, if I did not have the surgery. That comparison (6% vs 25%) was a "statistic" I could relate to.
 
I wouldn't necessarily encourage this, but since you asked... :wink2:

The Society of Thoracic Surgeons maintains a national database, and there is actually an accessible risk calculator for short term complications: http://www.sts.org/quality-research-patient-safety/quality/risk-calculator-and-models. I would certainly recommend caution in putting it to use, though, it is only as accurate (per national averages) as the quality of data input, so most patients probably will not know quite enough about their own medical profile to fully complete. However, for limited use, in can be informative...for evaluating variables at least. Judging the impact of age or another condition (diabetes in my case) against baseline, as an example.

Fortunately, as the others said, valve replacements patients generally have very low risks, big picture, even with some fairly major coexisting conditions. 1% is not necessarily flat-lining either...risks continue to minimize as time goes on, just not as noticeable since at the threshold of decimal points. 1 in 400 was reported by Cleveland Clinic for isolated AVR a few years ago I remember.
 
Don't have an studies to refer to, but at the time of my AVR in 2000, my surgeon told me the mortality rate was about 2%, but since I was relatively young (47) and in good shape, it was likely less than that. He also told me that the mortality risk roughly doubled for every re-op.

Mark
 
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