Abstract
The aim of this study was to evaluate the short-term operative results of patients with Marfan syndrome who underwent thoracic or abdominal aortic surgery in a 4-year period in Japan. Data were collected from the Japan Cardiovascular Surgery Database (JCVSD). We retrospectively analyzed the data of 845 patients with Marfan syndrome who underwent cardiovascular surgery between January 2008 and January 2011. Logistic regression was used to generate risk models. The early mortality rate was 4.4% (37/845). Odds ratios (OR), 95% confidence intervals (CI), and P values for structures and processes in the mortality prediction model were as follows: renal insufficiency (OR, 11.37; CI, 3.72-34.66; P < 0.001); respiratory disorder (OR, 11.12; CI, 3.20-38.67; P < 0.001); aortic dissection (OR, 13.02; CI, 2.80-60.60; P = 0.001); pseudoaneurysm (OR, 11.23; CI, 1.38-91.66; P = 0.024); thoracoabdominal aneurysm (OR, 2.67; CI, 1.22-5.84; P = 0.014); and aortic rupure (OR, 4.23; CI, 1.26-14.23; P = 0.002). The mortality prediction model had a C-index of 0.82 and a Hosmer-Lemeshow P value of 0.56. In conclusion, this study demonstrated that renal insufficiency and respiratory disorder had great impact on the operative mortality of Marfan patients undergoing cardiovascular surgery. Because patients with aortic dissection or aortic rupture showed high operative mortality, close follow-up to avoid emergency operation is mandatory to improve the operative results. Achieving good results from surgery of the thoraco-abdominal aorta was quite challenging, also in Marfan patients.
| Original language | English |
|---|---|
| Pages (from-to) | 401-404 |
| Number of pages | 4 |
| Journal | International Heart Journal |
| Volume | 54 |
| Issue number | 6 |
| Publication status | Published - 2013 |
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Keywords
- JACVSD
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Risk model of cardiovascular surgery in 845 Marfan patients using the Japan adult cardiovascular surgery database. / Miyairi, Takeshi; Miyata, Hiroaki; Taketani, Tsuyoshi; Sawaki, Daigo; Suzuki, Tohru; Hirata, Yasunobu; Shimizu, Hideyuki; Motomura, Noboru; Takamoto, Shinichi.
In: International Heart Journal, Vol. 54, No. 6, 2013, p. 401-404.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Risk model of cardiovascular surgery in 845 Marfan patients using the Japan adult cardiovascular surgery database
AU - Miyairi, Takeshi
AU - Miyata, Hiroaki
AU - Taketani, Tsuyoshi
AU - Sawaki, Daigo
AU - Suzuki, Tohru
AU - Hirata, Yasunobu
AU - Shimizu, Hideyuki
AU - Motomura, Noboru
AU - Takamoto, Shinichi
PY - 2013
Y1 - 2013
N2 - The aim of this study was to evaluate the short-term operative results of patients with Marfan syndrome who underwent thoracic or abdominal aortic surgery in a 4-year period in Japan. Data were collected from the Japan Cardiovascular Surgery Database (JCVSD). We retrospectively analyzed the data of 845 patients with Marfan syndrome who underwent cardiovascular surgery between January 2008 and January 2011. Logistic regression was used to generate risk models. The early mortality rate was 4.4% (37/845). Odds ratios (OR), 95% confidence intervals (CI), and P values for structures and processes in the mortality prediction model were as follows: renal insufficiency (OR, 11.37; CI, 3.72-34.66; P < 0.001); respiratory disorder (OR, 11.12; CI, 3.20-38.67; P < 0.001); aortic dissection (OR, 13.02; CI, 2.80-60.60; P = 0.001); pseudoaneurysm (OR, 11.23; CI, 1.38-91.66; P = 0.024); thoracoabdominal aneurysm (OR, 2.67; CI, 1.22-5.84; P = 0.014); and aortic rupure (OR, 4.23; CI, 1.26-14.23; P = 0.002). The mortality prediction model had a C-index of 0.82 and a Hosmer-Lemeshow P value of 0.56. In conclusion, this study demonstrated that renal insufficiency and respiratory disorder had great impact on the operative mortality of Marfan patients undergoing cardiovascular surgery. Because patients with aortic dissection or aortic rupture showed high operative mortality, close follow-up to avoid emergency operation is mandatory to improve the operative results. Achieving good results from surgery of the thoraco-abdominal aorta was quite challenging, also in Marfan patients.
AB - The aim of this study was to evaluate the short-term operative results of patients with Marfan syndrome who underwent thoracic or abdominal aortic surgery in a 4-year period in Japan. Data were collected from the Japan Cardiovascular Surgery Database (JCVSD). We retrospectively analyzed the data of 845 patients with Marfan syndrome who underwent cardiovascular surgery between January 2008 and January 2011. Logistic regression was used to generate risk models. The early mortality rate was 4.4% (37/845). Odds ratios (OR), 95% confidence intervals (CI), and P values for structures and processes in the mortality prediction model were as follows: renal insufficiency (OR, 11.37; CI, 3.72-34.66; P < 0.001); respiratory disorder (OR, 11.12; CI, 3.20-38.67; P < 0.001); aortic dissection (OR, 13.02; CI, 2.80-60.60; P = 0.001); pseudoaneurysm (OR, 11.23; CI, 1.38-91.66; P = 0.024); thoracoabdominal aneurysm (OR, 2.67; CI, 1.22-5.84; P = 0.014); and aortic rupure (OR, 4.23; CI, 1.26-14.23; P = 0.002). The mortality prediction model had a C-index of 0.82 and a Hosmer-Lemeshow P value of 0.56. In conclusion, this study demonstrated that renal insufficiency and respiratory disorder had great impact on the operative mortality of Marfan patients undergoing cardiovascular surgery. Because patients with aortic dissection or aortic rupture showed high operative mortality, close follow-up to avoid emergency operation is mandatory to improve the operative results. Achieving good results from surgery of the thoraco-abdominal aorta was quite challenging, also in Marfan patients.
KW - JACVSD
UR - http://www.scopus.com/inward/record.url?scp=84889016294&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84889016294&partnerID=8YFLogxK
M3 - Article
C2 - 24309451
AN - SCOPUS:84889016294
VL - 54
SP - 401
EP - 404
JO - International Heart Journal
JF - International Heart Journal
SN - 1349-2365
IS - 6
ER -