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Valvular & structural heart diseaseResearch article

Life expectancy and determinants of relative survival following surgical aortic valve replacement for aortic stenosis

HeartPublished

  • Flexible parametric models were used to estimate relative survival
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Authors' conclusion

In a contemporary population, relative survival following SAVR for significant AS was reduced compared with an age-matched, sex-matched and year-matched general population. Impaired LVEF, significant MR, Indigenous status, renal impairment and diabetes mellitus were independent predictors of long-term excess mortality. Timely intervention and optimised postoperative follow-up may be crucial for the restoration of normal life expectancy following SAVR.

Study context

Population
Patients undergoing Surgical Aortic Valve Replacement (SAVR) for ≥moderate Aortic Stenosis (AS), Western Australian Heart Valves Study databasemedian age 71 (63–77) years, 32% female
Participants
1,287 patients
Comparison
long-term relative survival following SAVR compared with the general population
  • SAVRn = 1,287

Main finding

As reported in the abstract

Deaths · median follow-up of 47 (23-81) months

SAVR

19%

247 of 1287

Further findings

Independent predictors of long-term excess mortality relative to the national comparator

Comparisonexcess HR (95% CI)P value
LVEF 45%-60% · Flexible multivariable modelling1.97 (1.11–3.51)P = 0.02
LVEF 30%-45% · Flexible multivariable modelling2.40 (1.24–4.64)P = 0.01
LVEF <30% · Flexible multivariable modelling2.96 (1.18–7.39)P = 0.02
significant MR · Flexible multivariable modelling2.28 (1.29–4.03)P = 0.005
Indigenous status · Flexible multivariable modelling4.53 (2.03–10.12)P < 0.001
diabetes mellitus · Flexible multivariable modelling2.30 (1.44–3.68)P < 0.001
eGFR 30-59 mL/kg/1.73 m 2 · Flexible multivariable modelling2.74 (1.33–5.65)P = 0.006
eGFR 0-29 mL/kg/1.73 m 2 · Flexible multivariable modelling5.75 (2.36–13.99)P < 0.001

All-cause relative survival

30-day
97.3%
1-year
97.2%
5-year
93.0%
10-year
83.3%
  • compared with an age-matched, sex-matched and year-matched general population

Independent predictors of long-term excess mortality relative to the national comparator

age, sex, year of surgery, concomitant coronary artery bypass graft surgery and symptom status were not associated

Original publication

Life expectancy and determinants of relative survival following surgical aortic valve replacement for aortic stenosis. Heart. Published 18 March 2026. doi:10.1136/heartjnl-2025-327029
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Summarised from the published abstract; every number is checked against it