Author + information
- Alan Zajarias,
- Marc Moon,
- Jennifer Lawton,
- Sunil Prasad,
- Michael Pasque,
- Scott Silvestry,
- Ralph J. Damiano Jr. and
- Hersh Maniar
Several studies have shown that African Americans (AA) and other minorities undergo invasive procedures less frequently than Caucasians. The influence of race on the rate of aortic valve replacement (AVR) for aortic stenosis (AS) has not been fully evaluated. We sought to determine if the preoperative characteristics and postoperative complications are influenced by race in patients undergoing AVR for AS.
Patients undergoing isolated AVR for AS from January 1, 2000 to December 31, 2011 who were integrated in the STS Adult Surgical Database were included. Patients with greater than moderate aortic insufficiency were excluded. Demographic, clinical, preoperative, operative and postoperative characteristics were evaluated and compared between racial groups. The influence of race on operative mortality, stroke, and prolonged post–operative length of stay (> 14 days) was determined by logistic regression.
When compared to Caucasians, AA had a higher surgical risk (p< 0.0001), greater co–morbidities (p<0.0001), and presented in more advanced heart failure (p<0.0001). AA patients were more prone to higher operative mortality(p< 0.0001), 30–day mortality (p< 0.0001), rehospitalization (p< 0.0001), and less likely to be discharged home.
On multivariate analysis, AA race is an independent predictor for prolonged ventilation (p–0.001), renal failure (p=0.001), pneumonia (p=0.001) and stroke (p=0.03).
AA patients have a higher rate of operative complications after isolated AVR for AS when compared to Caucasians due to their pre–existing conditions and presentation with more advanced disease states. Further studies to determine the reason of late presentation in non Caucasian patients are crucial in order to improve survival and access to medical care.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Valvular Heart Disease: Clinical VI – Prosthetic Valve
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1241–76
- 2013 American College of Cardiology Foundation