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000875339 0247_ $$2doi$$a10.1093/ejcts/ezz240
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000875339 1001_ $$0P:(DE-HGF)0$$aMinol, Jan-Philipp$$b0
000875339 245__ $$aThe age-adjusted Charlson comorbidity index in minimally invasive mitral valve surgery
000875339 260__ $$aOxford$$bOxford Univ. Press$$c2019
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000875339 520__ $$aOBJECTIVESMitral valve repair is the preferred method used to address mitral valve regurgitation, whereas transcatheter mitral valve repair is recommended for high-risk patients. We evaluated the risk-predictive value of the age-adjusted Charlson comorbidity index (aa-CCI) in the setting of minimally invasive mitral valve surgery.METHODSThe perioperative course and 1-year follow-up of 537 patients who underwent isolated or combined minimally invasive mitral valve surgery were evaluated for 1-year mortality as the primary end point and other adverse events. The predictive values of the EuroSCORE II and STS score were compared to that of the aa-CCI by a comparative analysis of receiver operating characteristic curves. Restricted cubic splines were applied to find optimal aa-CCI cut-off values for the increased likelihood of experiencing the predefined adverse end points. Consequently, the perioperative course and postoperative outcome of the aa-CCI ≥8 patients and the remainder of the sample were analysed.RESULTSThe predictive value of the aa-CCI does not significantly differ from those of the EuroSCORE II or STS score. Patients with an aa-CCI ≥8 were identified as a subgroup with a significant increase of mortality and other adverse events.CONCLUSIONSThe aa-CCI displays a suitable predictive ability for patients undergoing minimally invasive mitral valve surgery. In particular, multimorbid or frail patients may benefit from the extension of the objectively assessed parameters, in addition to the STS score or EuroSCORE II. Patients with an aa-CCI ≥8 have a very high surgical risk and should receive very careful attention.
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000875339 7001_ $$00000-0003-0152-8803$$aDimitrova, Vanessa$$b1
000875339 7001_ $$00000-0002-1045-6592$$aPetrov, Georgi$$b2
000875339 7001_ $$0P:(DE-Juel1)131693$$aLangner, Robert$$b3
000875339 7001_ $$0P:(DE-HGF)0$$aBoeken, Udo$$b4
000875339 7001_ $$0P:(DE-HGF)0$$aRellecke, Philipp$$b5
000875339 7001_ $$0P:(DE-HGF)0$$aAubin, Hug$$b6
000875339 7001_ $$0P:(DE-HGF)0$$aKamiya, Hiroyuki$$b7
000875339 7001_ $$0P:(DE-HGF)0$$aSixt, Stephan$$b8
000875339 7001_ $$0P:(DE-HGF)0$$aHuhn, Ragnar$$b9
000875339 7001_ $$0P:(DE-HGF)0$$aSugimura, Yukiharu$$b10
000875339 7001_ $$0P:(DE-HGF)0$$aAlbert, Alexander$$b11
000875339 7001_ $$0P:(DE-HGF)0$$aLichtenberg, Artur$$b12$$eCorresponding author
000875339 7001_ $$00000-0002-6452-8678$$aAkhyari, Payam$$b13
000875339 773__ $$0PERI:(DE-600)1500330-9$$a10.1093/ejcts/ezz240$$gVol. 56, no. 6, p. 1124 - 1130$$n6$$p1124 - 1130$$tEuropean journal of cardio-thoracic surgery$$v56$$x1873-734X$$y2019
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