Follow-up results
Table 3 lists the follow-up data. The median follow-up time was 5.6
years [2.0; 9.1], and 45 (88.2%) patients having follow-up TTE data
within the last 2 years. Two patients were considered lost to follow-up
because they have had no medical consultation for more than 10 years.
The 5-year overall survival was 90.9% (95% CI, 74.3%–97.0%), and
the 10-year overall survival was 84.9% (95% CI, 62.4%–94.4%). Four
(7.8%) patients died during the follow-up period, three following
stroke and one from drowning. The strokes, one of them hemorrhagic and
the other two of unknown etiology, occurred more than 3 years after the
surgery (3.5, 3.9 and 8.9 years after, respectively), and the mean age
at death was 58.8±4.5 years. Rehospitalization was reported for 18
patients, 7 of them (13.7%) for cardiac events: two with endocarditis
necessitating Bentall’s procedure with mechanical prosthesis at 15
months and 93 months, respectively, and one with mitral insufficiency at
4.5 years after the Tirone procedure. For this last patient,
echocardiography showed a modified aortic valve associated with
stenosis, so reoperation consisted of a double biological replacement
valve. Two patients had been treated for atrial fibrillation, and two
others had a pacemaker implanted well after the surgery. There were no
deaths with reinterventions.
Regarding medical outcomes, 45 patients had not had discomfort since
surgery and three had New York Heart Association (NYHA) II dyspnea.
Three others patients (5.9%) needed an anticoagulant drug, while six
(11.8%) were without medication. The reports were all from recent
follow-up, with less than one year since Canadian Cardiovascular Society
and NYHA classification, and less than 2 years for transesophageal
echography TEE-related data and events since surgery. The follow-up TEE
data showed ejection fraction at 62.6±6.7% (n=36) and a
Vmax 2.0±0.6 m/s (n=17), a mean gradient of 9.4±5.4 mmHg
(n=27), and no grade III or IV aortic regurgitation (Table 3).