Life expectancy after surgical aortic valve replacement for low-gradient aortic stenosis with preserved ejection fraction.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hernández-Vaquero Daniel, Rodríguez-Caulo Emiliano, Vigil-Escalera Carlota, Blanco-Herrera Óscar, Berastegui Elisabet, Arias-Dachary Javier, Souaf Souhayla, Parody Gertrudis, Laguna Gregorio, Adsuar Alejandro, Castellá Manel, Valderrama José F, Pulitani Ivana, Cánovas Sergio, Ferreiro Andrea, García-Valentín Antonio, Carnero Manuel, Pareja Pilar, Corrales José A, Blázquez José A, Macías Diego, Fletcher-Sanfeliu Delfina, Martínez Daniel, Martín Elio, Martín Miren, Margarit Juan, Hernández-Estefanía Rafael, Monguió Emilio, Otero Juan, Silva Jacobo
Аннотация
METHODS: We included all patients between 50 and 65 years who underwent isolated SAVR in 27 Spanish centers during an 18-year period. We analyzed observed and expected survival at 18 years in patients with low-gradient SAS with preserved LVEF and all other types of SAS. We used propensity score matching to compare the life expectancy of patients with low-gradient SAS with preserved LVEF vs those with high-gradient SAS with preserved LVEF.
RESULTS: We analyzed 5084 patients, of whom 413 had low-gradient SAS with preserved LVEF. For these patients, observed survival at 10, 15 and 18 years was 86.6% (95%CI, 85.3-87.8), 75% (95%CI, 72.7-77.2), and 63.5% (95%CI, 58.8-67.8). Expected survival at 10, 15 and 18 years was 90.2%, 82.1%, and 75.7%. In the matched sample, survival of patients with low-gradient SAS with preserved LVEF was similar to that of patients with high-gradient with preserved LVEF, log-rank test, P=.95; HR=1 (95%CI, 0.7-1.4; P=.95).
CONCLUSIONS: There is a loss of life expectancy in patients with all types of SAS undergoing SAVR. This loss is higher in patients with left ventricular dysfunction and lower in patients with low-gradient or high-gradient aortic stenosis with preserved LVEF. The benefit of surgery is similar between these last 2 groups.