PMID- 12204512
OWN - NLM
STAT- MEDLINE
DCOM- 20020917
LR  - 20220331
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 40
IP  - 4
DP  - 2002 Aug 21
TI  - Severe pulmonary hypertension in patients with severe aortic valve stenosis: 
      clinical profile and prognostic implications.
PG  - 789-95
AB  - OBJECTIVES: We analyzed the clinical characteristics and outcomes of 47 patients 
      with severe pulmonary hypertension (PHT) and severe aortic valve stenosis (AS) 
      from 1987 to 1999. BACKGROUND: The prognostic implications of severe pulmonary 
      hypertension in patients with severe AS are poorly understood. METHODS: The mean 
      age of patients was 78 years (range 47 to 91 years), and 37 patients (79%) were 
      in New York Heart Association (NYHA) functional class III or IV. Aortic valve 
      replacement (AVR) was performed in 37 patients (79%) and 10 patients (21%) were 
      treated conservatively. RESULTS: In the group that had AVR, there were six 
      perioperative deaths (16%) and nine late deaths, resulting in a total mortality 
      of 32%. In the conservatively treated group, there were eight deaths (80%) on 
      follow-up. Severe PHT was an independent predictor of perioperative mortality. 
      However, perioperative mortality was independent of the severity of left 
      ventricular systolic dysfunction or concomitant coronary artery bypass grafting. 
      Aortic valve replacement was associated with significant improvement in left 
      ventricular ejection fraction, the severity of PHT and NYHA functional class. The 
      difference between long-term survival of the operative survivors and the expected 
      survival from life tables was not statistically significant. CONCLUSIONS: The 
      prognosis for patients with AS and severe PHT treated conservatively without AVR 
      is dismal. Although AVR is associated with higher than usual mortality, the 
      potential benefits outweigh the risk of surgery.
FAU - Malouf, Joseph F
AU  - Malouf JF
AD  - Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, 
      Rochester, Minnesota 55905, USA.
FAU - Enriquez-Sarano, Maurice
AU  - Enriquez-Sarano M
FAU - Pellikka, Patricia A
AU  - Pellikka PA
FAU - Oh, Jae K
AU  - Oh JK
FAU - Bailey, Kent R
AU  - Bailey KR
FAU - Chandrasekaran, Krishnaswamy
AU  - Chandrasekaran K
FAU - Mullany, Charles J
AU  - Mullany CJ
FAU - Tajik, A Jamil
AU  - Tajik AJ
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
CIN - J Am Coll Cardiol. 2003 May 21;41(10):1847-8; author reply 1848. PMID: 12767677
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Valve Stenosis/*complications/mortality/surgery
MH  - Echocardiography, Doppler
MH  - Female
MH  - *Heart Valve Prosthesis Implantation/mortality
MH  - Hemodynamics
MH  - Humans
MH  - Hypertension, Pulmonary/*complications/mortality
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Survival Analysis
EDAT- 2002/09/03 10:00
MHDA- 2002/09/18 10:01
CRDT- 2002/09/03 10:00
PHST- 2002/09/03 10:00 [pubmed]
PHST- 2002/09/18 10:01 [medline]
PHST- 2002/09/03 10:00 [entrez]
AID - S0735109702020028 [pii]
AID - 10.1016/s0735-1097(02)02002-8 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Aug 21;40(4):789-95. doi: 10.1016/s0735-1097(02)02002-8.