The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2009
Severe aortic regurgitation and reduced left ventricular ejection fraction: outcomes after isolated aortic valve replacement and combined surgery.
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Sionis Alessandro, García-Alvarez Ana, Castel María Angeles, Cordero Marco, Josa Miguel, Pérez-Villa Félix, Roig Eulàlia
Аннотация
BACKGROUND: In patients with severe aortic regurgitation and reduced left ventricular ejection fraction (LVEF), uncertainty remains whether to recommend aortic valve replacement (AVR) over heart transplantation, especially when mitral regurgitation and/or coronary heart disease coexist.
METHODS: We assessed outcomes in 26 consecutive AVR patients aged </=70 years with severe aortic regurgitation and reduced LVEF, comparing the group undergoing isolated AVR with the group requiring combined surgery.
RESULTS: The difference in mortality and morbidity between the groups was 10% vs 6%, which was not significant (p = 0.6 in both cases). Also observed was a significant improvement in functional class and a reduction in LV end-diastolic diameter from a median value of 69 to 64 mm in the isolated AVR group and to 66 mm in the combined group (p < 0.05).
CONCLUSIONS: AVR in patients with symptomatic severe aortic regurgitation and reduced LVEF is feasible, even in the presence of concomitant mitral regurgitation and/or coronary heart disease requiring a combined surgical procedure.
METHODS: We assessed outcomes in 26 consecutive AVR patients aged </=70 years with severe aortic regurgitation and reduced LVEF, comparing the group undergoing isolated AVR with the group requiring combined surgery.
RESULTS: The difference in mortality and morbidity between the groups was 10% vs 6%, which was not significant (p = 0.6 in both cases). Also observed was a significant improvement in functional class and a reduction in LV end-diastolic diameter from a median value of 69 to 64 mm in the isolated AVR group and to 66 mm in the combined group (p < 0.05).
CONCLUSIONS: AVR in patients with symptomatic severe aortic regurgitation and reduced LVEF is feasible, even in the presence of concomitant mitral regurgitation and/or coronary heart disease requiring a combined surgical procedure.