SYSTEMIC HYPERTENSION AS A RISK FACTOR FOR COMPLICATIONS WITH AN AORTIC MECHANICAL VALVE

We sought to determine the effect of preoperative systemic hypertensio n on prosthesis related complications or postoperative aortic dissecti on after valve replacement in patients with aortic regurgitation. The patients were divided into two groups according to the presence or abs ence of systemic hypertension: Group I, with hypertension (n = 35), an d Group II, without hypertension (n = 37). The survival rate and event free rate were examined for 72 patients who were alive 30 days after valve replacement with a St. Jude Medical valve for aortic regurgitati on. The cumulative 10 year survival rate of Group I (65% +/- 12%) was lower than that of Group II (79% +/- 15%). The 10 year event free rate of all prosthesis related complications was 62% +/- 13% in Group I, a nd 96% +/- 13% in Group II (p < 0.05). The 10 year event free rate for ascending aortic dissection was 73% +/- 12% in Group I and 100% in Gr oup II (p < 0.05). The linearized event rate of all prosthesis related complication was 3.8% per patient-year in Group I and 0.5% per patien t-year in Group II. In conclusion, systemic hypertension was a risk fa ctor for prosthesis related complications and for complicated aortic l esions after aortic valve replacement. Careful postoperative managemen t for hypertension is necessary in patients with systemic hypertension after aortic valve replacement. Tissue valves may be recommended in p atients with aortic valve disease and severe hypertension.