Please use this identifier to cite or link to this item: http://hdl.handle.net/1946/39624
Objective: This study seeks to examine if the presence of mitral annular calcification (MAC) impacts major outcomes, hospital length of stay and survival following a non-mitral valve cardiac surgery.
Methods: A single-center retrospective study including 728 patients who underwent surgical aortic valve replacement (SAVR), coronary artery bypass grafting (CABG) and combined SAVR and CABG from 2013 – 2016. The cohort was divided into patients with MAC (n=151) and patients without MAC(n=577). Mean survival follow-up time was 4.0 years. Kaplan – Meier analysis was performed to estimate 1-year survival. In addition, univariate and multivariate Cox proportional-hazards analysis
was performed to identify variables affecting survival. Linear regression was used to assess hospital length of stay (LOS). Major outcomes were assessed by using logistics regression presented as mean and median.
Results: Kaplan - Meier (p= 0.0052) and univariate Cox proportional-hazard survival analysis (HR:1.63 CI: 1.152 - 2.306, p = 0.00584) demonstrated a significant difference in survival between the two groups. Adjusting using multivariate Cox modeling no statistically significant difference was noted in survival (p= 0.428). Patients with MAC were more likely to have at least one major adverse outcome (17.9% vs. 14.4%). In multiple analysis MAC was not found to be an independent predictor of major adverse outcomes (OR 1.02, CI: 0.95 – 1.09, p = 0.543). The median time for postoperative LOS was the same in both groups, that is 6 days. When looking at the mean LOS a difference can be detected. The mean for MAC patients was 9.21 (IQR: 5-10 days) and 7.53 (IQR: 5-8 days) for non-MAC patients. Linear multivariate regression for LOS showed that the difference in LOS was insignificant between the groups (p=0.11).
Conclusions: No association was found between MAC and survival, where the difference in survival disappears when adjusting for confounders. The unadjusted difference in survival is likely due to age difference between the MAC and non-MAC patient groups. Also, there is no association between the two groups in regard to LOS and major outcomes.
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