Back to Search
Start Over
Valve replacement for severe aortic stenosis with low transvalvular gradient and left ventricular ejection fraction exceeding 0.50
- Source :
- The Annals of thoracic surgery. 91(6)
- Publication Year :
- 2010
-
Abstract
- Background Severe aortic stenosis with a low transvalvular gradient and preserved left ventricular ejection fraction (LVEF) is often misdiagnosed, leading to undertreatment of such patients with no clear indication for surgical intervention. This study investigated the outcome of aortic valve replacement (AVR) in patients with severe aortic stenosis and a low transvalvular gradient despite normal LVEF. Methods Between 1985 and 2008, we evaluated 73 patients who underwent AVR compared with 29 patients who did not. Overall, aortic valve area was 1.0 cm 2 or smaller, LVEF was 0.50 or higher, and transvalvular gradient was 30 mm Hg or less. Multivariate and Cox analyses were used to compare these two groups according to AVR. Results Compared with controls, AVR patients were younger and with higher body mass index. Coronary artery bypass grafting was performed simultaneously in 38 AVR patients (52%). At follow-up (median, 42 months; interquartile range, 23 to 75 months), survival was longer in AVR patients. By Cox analysis, AVR remained a major predictor of lower mortality (hazard ratio, 0.237; 95% confidence interval, 0.119 to 0.470; p Conclusions In patients with severe aortic stenosis and low transvalvular gradient despite a normal LVEF, AVR was associated with significant improvement in long-term survival and functional status and with a low operative mortality.
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
medicine.medical_treatment
Ventricular Function, Left
Coronary artery disease
Valve replacement
Aortic valve replacement
Interquartile range
Internal medicine
Medicine
Humans
Coronary Artery Bypass
Aged
Proportional Hazards Models
Aged, 80 and over
Heart Valve Prosthesis Implantation
Ejection fraction
business.industry
Hazard ratio
Stroke Volume
Stroke volume
Aortic Valve Stenosis
medicine.disease
Surgery
Stenosis
Aortic Valve
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 15526259
- Volume :
- 91
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The Annals of thoracic surgery
- Accession number :
- edsair.doi.dedup.....a49ee905d27f34d0f856e4c0a0bb75fe