[Natural history of patients with severe aortic valve disease under medical therapy (author's transl)].

65 patients out of 420 with aortic valve lesions (class III and IV NYHA) who underwent cardiac catheterization in 1967-1976 were not operated upon for different reasons. The fate of these 65 patients was analyzed retrospectively to elucidate the natural history of severe aortic valve disease. The five years survival rate was 26% (aortic stenosis 17%, aortic incompetence 37%). Patients with angina pectoris and congestive heart failure, ventricular ectopic beats, mean pulmonary artery pressure greater than 30 mm Hg, mean left atrial pressure greater than 16 mm Hg and left ventricular enddiastolic pressure greater than 20 mm Hg had a significant worse prognosis than those without these parameters. Otherwise patients who refused the operation by personal reasons had a high survival rate. The results of the study indicate that patients with aortic valve disease class III or IV (NYHA) have a serious prognosis when treated medically. In comparison with our patients who underwent aortic valve replacement surgery has proven to be a life-prolonging procedure in these highly endangered cases.