PMID- 30174847
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220321
IS  - 2072-1439 (Print)
IS  - 2077-6624 (Electronic)
IS  - 2072-1439 (Linking)
VI  - 10
IP  - 7
DP  - 2018 Jul
TI  - Outcomes of surgical aortic valve replacement for mixed aortic valve disease.
PG  - 4042-4051
LID - 10.21037/jtd.2018.06.128 [doi]
AB  - BACKGROUND: Mixed aortic valve disease (MAVD) is associated with a poorer natural 
      history compared with isolated lesions. However, clinical and echocardiographic 
      outcomes for aortic valve replacement (AVR) in mixed disease are less well 
      understood. METHODS: Retrospective review of AVRs (n=1,011) from 2000-2016. 
      Isolated AVR, AVR + coronary bypass, and AVR + limited ascending aortic 
      replacement were included. Predominant aortic stenosis (AS) group was stratified 
      into group 1 (n=660) with concomitant mild or less aortic insufficiency (AI), and 
      group 2 (n=197) with accompanying moderate or greater AI. Predominant AI group 
      was stratified using the same schema for concomitant AS into groups 3 (n=143) and 
      4 (n=53). Median follow-up was 3.1 and 4.4 years respectively for AS and AI 
      groups. RESULTS: For the predominant AS group (n=857) preoperatively, group 2 had 
      a larger preoperative left ventricular end diastolic diameter (LVESD) (51.0+/-8.4 
      vs. 48.6+/-7.2, P=0.02) and lower preoperative left ventricular ejection fraction 
      (LVEF) (57.6% vs. 60.2%, P=0.043). No differences in left ventricular (LV) 
      dimensions, LV or right ventricular (RV) function was evident at follow up 
      (P>0.05). After propensity matching for age, operation, and comorbidities, there 
      was no difference in survival (P=0.19). After propensity matching for the 
      predominant AI group (n=196), survival was lower for group 4 compared to 3 
      (P=0.02). There were no differences in LV dimensions, LV or RV function 
      preoperatively or on follow-up (P>0.05). CONCLUSIONS: Predominant AS associated 
      with higher AI grades had larger LV dimensions and worse LV function 
      preoperatively. These differences resolve after AVR with equivalent survival. 
      However, predominant AI with more severe AS had reduced survival despite AVR.
FAU - Philip, Jennifer L
AU  - Philip JL
AD  - Department of Surgery, Division of General Surgery, University of Wisconsin 
      School of Medicine and Public Health, Madison, Wisconsin, USA.
FAU - Zens, Tiffany
AU  - Zens T
AD  - Department of Surgery, Division of General Surgery, University of Wisconsin 
      School of Medicine and Public Health, Madison, Wisconsin, USA.
FAU - Lozonschi, Lucian
AU  - Lozonschi L
AD  - Department of Surgery, Division of Cardiothoracic Surgery, Medical University of 
      South Carolina, Charleston, South Carolina, USA.
FAU - De Oliveira, Nilto C
AU  - De Oliveira NC
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
FAU - Osaki, Satoru
AU  - Osaki S
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
FAU - Kohmoto, Takushi
AU  - Kohmoto T
AD  - Department of Surgery, Division of Cardiothoracic Surgery, University of 
      Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
FAU - Akhter, Shahab A
AU  - Akhter SA
AD  - Department of Cardiovascular Sciences, Division of Cardiac Surgery, East Carolina 
      Heart Institute at East Carolina University, Greenville, North Carolina, USA.
FAU - Tang, Paul C
AU  - Tang PC
AD  - Department of Cardiac Surgery, University of Michigan Frankel Cardiovascular 
      Center, Ann Arbor, Michigan, USA.
LA  - eng
GR  - T32 HL110853/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - China
TA  - J Thorac Dis
JT  - Journal of thoracic disease
JID - 101533916
PMC - PMC6106000
OTO - NOTNLM
OT  - Aortic valve (AV)
OT  - heart failure
OT  - heart valves
OT  - multiple
OT  - outcomes
OT  - replacement
COIS- Conflicts of Interest: The authors have no conflicts of interest to declare.
EDAT- 2018/09/04 06:00
MHDA- 2018/09/04 06:01
PMCR- 2018/07/01
CRDT- 2018/09/04 06:00
PHST- 2018/09/04 06:00 [entrez]
PHST- 2018/09/04 06:00 [pubmed]
PHST- 2018/09/04 06:01 [medline]
PHST- 2018/07/01 00:00 [pmc-release]
AID - jtd-10-07-4042 [pii]
AID - 10.21037/jtd.2018.06.128 [doi]
PST - ppublish
SO  - J Thorac Dis. 2018 Jul;10(7):4042-4051. doi: 10.21037/jtd.2018.06.128.