{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:48:05Z","timestamp":1772131685454,"version":"3.50.1"},"reference-count":34,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006520","name":"Edwards Lifesciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006520","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,9,21]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To date the reported outcomes of surgical aortic valve replacement (SAVR) are mainly in the settings of trials comparing it with evolving transcatheter aortic valve implantation. We set out to examine characteristics and outcomes in people who underwent SAVR reflecting a national cohort and therefore \u2018real-world\u2019 practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective analysis of prospectively collected data of consecutive people who underwent SAVR with or without coronary artery bypass graft (CABG) surgery between April 2013 and March 2018 in the UK. This included elective, urgent and emergency operations. Participants\u2019 demographics, preoperative risk factors, operative data, in-hospital mortality, postoperative complications and effect of the addition of CABG to SAVR were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>27 (90%) tertiary cardiac surgical centres in the UK submitted their data for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>31\u2009277 people with AVR were identified. 19\u2009670 (62.9%) had only SAVR and 11\u2009607 (37.1%) had AVR+CABG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In-hospital mortality for isolated SAVR was 1.9% (95% CI 1.6% to 2.1%) and was 2.4% for AVR+CABG. Mortality by age category for SAVR only were: &lt;60 years=2.0%, 60\u201375 years=1.5%, &gt;75 years=2.2%. For SAVR+CABG these were; 2.2%, 1.8% and 3.1%. For different categories of EuroSCORE, mortality for SAVR in low risk people was 1.3%, in intermediate risk 1% and for high risk 3.9%. 74.3% of the operations were elective, 24% urgent and 1.7% emergency\/salvage. The incidences of resternotomy for bleeding and stroke were 3.9% and 1.1%, respectively. Multivariable analyses provided no evidence that concomitant CABG influenced outcome. However, urgency of the operation, poor ventricular function, higher EuroSCORE and longer cross clamp and cardiopulmonary bypass times adversely affected outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgical SAVR\u00b1CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.<\/jats:p><\/jats:sec>","DOI":"10.1136\/bmjopen-2020-046491","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T16:40:21Z","timestamp":1635439221000},"page":"e046491","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national 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