Predictors of outcome in a multicenter port-access valve registry

Background. The aim of this study was to examine the predictors of outcome in patients undergoing isolated valve operation using port-access technique s. Methods. Logistic regression analysis was performed in a prospective, multi -institutional registry of patients undergoing isolated aortic valve replac ement (AVR, n = 252), mitral repair (MVP, n = 491), or mitral replacement ( MVR, n = 568) using port-access techniques from 1997 to 1999. Results. Endoaortic balloon occlusion was used in 2% (AVR), 93% (MVP), and 90% (MVR) of cases. Conversion to full sternotomy occurred in 3.8% of all c ases. For all patients, early mortality was 50 of 1,311 (3.8%) and onset of new atrial fibrillation occurred in 140 of 1,311 (11%) patients. The deter minants of 30-day mortality were redo, age, and MVR or AVR. The determinant s of reoperation for bleeding were age, reoperation, and MVR. Age was a pre dictor for stroke, and age and low or medium volume center were predictors of new atrial fibrillation. Conclusions. Excellent short-term results can be obtained using port-access techniques in isolated mitral or aortic valve operations. Patient outcome is not related to institutional case volume, and the primary determinants o f outcome after port-access valve procedures are generally patient-related factors. (Ann Thorac Surg 2000;70:1054-9) (C) 2000 by The Society of Thorac ic Surgeons.