PMID- 12754021
OWN - NLM
STAT- MEDLINE
DCOM- 20030814
LR  - 20190513
IS  - 1010-7940 (Print)
IS  - 1010-7940 (Linking)
VI  - 23
IP  - 5
DP  - 2003 May
TI  - Aortic valve replacement for aortic regurgitation and stenosis, in patients with 
      severe left ventricular dysfunction.
PG  - 703-9; discussion 709
AB  - OBJECTIVE: Aortic valve replacement for aortic valve stenosis (AS) and 
      regurgitation (AR) in patients with severe left ventricular (LV) dysfunction 
      contains an increased risk. Few data are available on the outcome of such 
      patients. METHODS: Fifty-five consecutive patients with severe LV dysfunction 
      (ejection fraction, EF; <30%) and aortic valve replacement for AS (n=35) or AR 
      (n=20) were investigated between 1994 and 2001. EF was 25+/-5%, mean 
      transvalvular gradient 26+/-6mmHg (AS), aortic valve area 0.66+/-0.18cm(2) (AS), 
      cardiac index (CI) 2.4+/-0.9l/min/m(2), enddiastolic LV diameter (LVEDD) 64+/-8mm 
      and endsystolic LV diameters (LVESD) was 55+/-3mm. Ninety percent of patients 
      were in New York Heart Association (NYHA) functional class III/IV at admission to 
      the hospital. Concomitant coronary artery bypass grafts (CABG) were performed in 
      14 patients. Follow-up examinations including chest X-ray, echocardiography, 
      exercise testing, were performed among survivors. RESULTS: The survival rates for 
      AS were: 1-year 76%, 2-year 68.8%, 5-year 64.2%; for AR: 1-year 94.4%, 2-year 
      86.5%, 5-year 74.2%. NYHA functional class improved from 90% in class III/IV to 
      45 (AR group) and 24% (AS group) at follow-up (P<0.02). The LVEDD decreased to 
      54+/-8mm after 1 year. The EF improved to 38+/-4 (AR group) and 40+/-5% (AS 
      group) at follow-up. CONCLUSIONS: Despite severe LV dysfunction, increased 1-year 
      mortality especially in the AS group, aortic valve replacement was associated 
      with improved functional status, symptoms and EF in both groups and in most 
      patients. We, therefore, conclude that aortic valve replacement in patients with 
      severe LV dysfunction can be performed with acceptable risk.
FAU - Rothenburger, Markus
AU  - Rothenburger M
AD  - Department of Thoracic and Cardiovascular Surgery, University Hospital Muenster, 
      Muenster, Germany. markus.rothenburger@thgms.uni-muenster.de
FAU - Drebber, Karin
AU  - Drebber K
FAU - Tjan, Tonny D T
AU  - Tjan TD
FAU - Schmidt, Christoph
AU  - Schmidt C
FAU - Schmid, Christof
AU  - Schmid C
FAU - Wichter, Thomas
AU  - Wichter T
FAU - Scheld, Hans Heinrich
AU  - Scheld HH
FAU - Deiwick, Michael
AU  - Deiwick M
LA  - eng
PT  - Journal Article
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aortic Valve/*surgery
MH  - Aortic Valve Insufficiency/*surgery
MH  - Aortic Valve Stenosis/*surgery
MH  - Echocardiography, Doppler
MH  - Female
MH  - Follow-Up Studies
MH  - *Heart Valve Prosthesis
MH  - Heart Valve Prosthesis Implantation/*methods/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Odds Ratio
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*complications
EDAT- 2003/05/20 05:00
MHDA- 2003/08/15 05:00
CRDT- 2003/05/20 05:00
PHST- 2003/05/20 05:00 [pubmed]
PHST- 2003/08/15 05:00 [medline]
PHST- 2003/05/20 05:00 [entrez]
AID - S1010794003000307 [pii]
AID - 10.1016/s1010-7940(03)00030-7 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2003 May;23(5):703-9; discussion 709. doi: 
      10.1016/s1010-7940(03)00030-7.