Fernando A. Atik, MD, Lars G. Svensson, MD, PhD, FACC, Eugene H

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Presentation transcript:

Less invasive versus conventional double-valve surgery: A propensity-matched comparison Fernando A. Atik, MD, Lars G. Svensson, MD, PhD, FACC, Eugene H. Blackstone, MD, FACC, A. Marc Gillinov, MD, FACC, Jeevanantham Rajeswaran, MSc, Bruce W. Lytle, MD, FACC The Journal of Thoracic and Cardiovascular Surgery Volume 141, Issue 6, Pages 1461-1468.e4 (June 2011) DOI: 10.1016/j.jtcvs.2010.05.053 Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Mirrored histogram of distribution of propensity scores for conventional (bars above zero line) and less invasive (bars below zero line) approaches. The darkened area represents matched patient pairs, showing that they cover the complete spectrum of cases. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Temporal pattern of postextubation forced expiratory volume in 1 second (FEV1) as a percentage of predicted value after less invasive and conventional double-valve surgery in propensity-matched groups. Solid lines are parametric estimates of temporal trend enclosed within dashed lines (68% confidence limits, equivalent to ± 1 standard error). Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. NHANES, National Health and Nutrition Examination Survey. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Temporal pattern of pain-score categories after double-valve surgery in propensity-matched patients. Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. Solid lines are parametric estimates of percentage of patients in each category. A, All patients, all pain-score categories. B, Proportion of patients without pain (category 0) after less invasive surgery (squares) versus conventional sternotomy (circles). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Survival after conventional double-valve surgery versus less invasive surgery in propensity-matched groups. Each symbol represents a death positioned actuarially, vertical bars represent 68% confidence limits, and numbers in parentheses represent patients remaining at risk. Solid lines are parametric estimates enclosed within dashed 68% confidence limits (equivalent to ± 1 standard error). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Risk-unadjusted depiction of temporal pattern of postextubation forced expiratory volume in 1 second (FEV1) as a percentage of predicted value after less invasive double-valve surgery and conventional surgery in overall groups. Solid lines are parametric estimates of temporal trend enclosed within dashed lines (68% confidence limits, equivalent to ± 1 standard error). Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Risk-unadjusted estimate of temporal pattern of pain-score categories after double-valve surgery. Symbols represent data grouped within time frames without regard for repeated assessment simply to provide crude verification of model fit. Solid lines are parametric estimates of percentage of patients in each category. A, All patients, all pain-score categories. B, Proportion of patients without pain (category 0) after less invasive surgery (squares) and conventional sternotomy (circles). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions

Risk-unadjusted estimates of survival after less invasive double-valve surgery versus conventional surgery. Each symbol represents a death positioned actuarially, vertical bars represent 68% confidence limits, and numbers in parentheses represent patients remaining at risk. Solid lines are parametric estimates enclosed within dashed lines (68% confidence limits, equivalent to ± 1 standard error). The Journal of Thoracic and Cardiovascular Surgery 2011 141, 1461-1468.e4DOI: (10.1016/j.jtcvs.2010.05.053) Copyright © 2011 The American Association for Thoracic Surgery Terms and Conditions