In his PhD thesis, Andreas Auensen found high survival and increased quality of life at long-term follow-up after surgery for aortic stenosis.
- Nine out of ten patients with severe aortic stenosis were still alive three years after aortic valve replacement.
- Patients reported clinically significant improvements in health-related quality of life following aortic valve surgery.
- Biomarkers of cardiac dysfunction, myocardial damage or inflammation were not associated with risk of dying during follow-up after aortic valve replacement.
Thesis: Prognostic factors and outcomes in patients with severe aortic stenosis referred for evaluation of possible surgical aortic valve replacement
Candidate: Andreas Auensen
Time: February 1, 2018 at 12:15
Place: Oslo University Hospital, Rikshospitalet: Blue Auditorium
Link to university website (in Norwegian)
(1) Three years after surgical aortic valve replacement, 316 of 351 included patients were still alive. Moreover, symptom burden was significantly reduced one year after surgery, and there were signs of reduced cardiac remodelling. The percentage of patients who were both free of symptoms and lived independently increased from 5.5 % before surgery to 49.1 % one year later.
Among the 91 patients who were not operated, only 45 were still alive three years later. These patients were not operated either because they lacked symptoms, because the risk was too high, or because they did not want surgery.
(3) Health-related quality of life improved significantly in operated patients, but moved in the other directon for most unoperated patients. Both physical function, pain, vitality, general and mental health improved following surgery, and for many of the patients the improvements were large enough to be clinically relevant.
(2) Neither BNP, troponin T or CRP levels were associated with three-year mortality following aortic valve surgery. However, higher levels of high-sensitive troponin T were linked to about 50 % increased risk of an adverse cardiac event during the first year of follow-up. Among unoperated patients, all three markers were associated with increased risk of all-cause and cardiovascular mortalty within three years.
(1) Auensen, A., Hussain, A. I., Bendz, B., Aaberge, L., Falk, R. S., Walle-Hansen, M. M., Bye, J., Andreassen, J., Beitnes, J. O., Rein, K. A., Pettersen, K. I., & Gullestad, L. (2017). Morbidity outcomes after surgical aortic valve replacement. Open Heart, 4(1), e000588.
(2) Auensen, A., Hussain, A. I., Falk, R. S., Walle-Hansen, M. M., Bye, J., Pettersen, K. I., Aukrust, P., Ueland, T., & Gullestad, L. L. (2017). Associations of brain-natriuretic peptide, high-sensitive troponin T, and high-sensitive C-reactive protein with outcomes in severe aortic stenosis. PloS one, 12(6), e0179304.
(3) Auensen, A., Hussain, A. I., Garratt, A. M., Gullestad, L. L., & Pettersen, K. I. (2017). Patient-reported outcomes after referral for possible valve replacement in patients with severe aortic stenosis. European Journal of Cardio-Thoracic Surgery, 53(1), 129-135.