Long Term Results of Valve Operations in Patients with Diabetes

Stephen J. Huddleston, Erin Goheen, Isaac Opoku-Asare, Peter Kokkinos, Michael D. Greenberg, Gregory D. Trachiotis

Department of Surgery, Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, and the Departments of Medicine and Cardiology and Cardiothoracic Surgery at The Washington DC Veterans Affairs Medical Center and The George Washington.
Department of Surgery, Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, and the Departments of Medicine and Cardiology and Cardiothoracic Surgery at The Washington DC Veterans Affairs Medical Center and The George Washington University, Washington, USA.
Department of Surgery, Division of Cardiac Surgery, The Johns Hopkins Medical Institutions, and the Departments of Medicine and Cardiology and Cardiothoracic Surgery at The Washington DC Veterans Affairs Medical Center, and The George Washington University, Washington, USA.

DOI: 10.4236/wjcs.2012.24013                

Abstract

Diabetes Mellitus (DM) adversely affects survival in patients with Coronary Artery Disease (CAD) undergoing Coronary Artery Bypass Grafting (CABG) surgery. The influence of diabetes on events after valve operations is less defined. We analyzed the effect of diabetes on short and long term outcomes in patients undergoing valvular operations. A total of 2200 patients had cardiac surgery at a single VA Medical Center between 1991 and 2008. 355 patients had undergone valve replacement or repair. Data documenting the presence of diabetes was collected prospectively and captured into the Veterans Affairs electronic medical record. Of the 355 patients who had a valvular operation, 259 (79%) had an Aortic Valve Replacement (AVR), 69 (20%) had a Mitral Valve Repair/Replacement (MVR), and 4 (1%) had a Tricsupid Valve Repair/Replacement (TVR), and 19% (n = 69) of all patients had diabetes. 44% of patients with DM and 38% of patients without DM had a combined valve and CABG procedure. During a total follow up of 18 yrs, 42 (60%) of patients with diabetes and 186 (65%) of patients without diabetes were alive (p = 0.118). At 1, 5, 10, 15 yrs survival in patients with versus without diabetes were 91% v 87%; 71% v 74%; 40% v 56%; 23% v 48% (p = NS). The presence of diabetes does not appear to adversely effect long-term survival in patients undergoing valve operations.

Keywords

Cardiac; Heart Valve; Diabetes

Conflicts of Interest

The authors declare no conflicts of interest.

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