Author + information
- Chisato Izumi,
- Masashi Amano,
- Masako Hayama,
- Seiko Nakajima,
- Yodo Tamaki,
- Makoto Miyake,
- Hirokazu Kondo,
- Toshihiro Tamura,
- Kazuaki Kaitani and
- Yoshihisa Nakagawa
Aortic valve replacement (AVR) is recommended for patients with severe chronic aortic regurgitation (AR) before left ventricular (LV) dysfunction develops. However, because asymptomatic status lasts long, patients with severe chronic AR sometimes show LV dysfunction at the initial diagnosis. The purpose of this study is to clarify long–term outcomes and chronological changes of LV function after AVR in patients with severe chronic AR.
We retrospectively investigated 80 consecutive patients with severe chronic AR who underwent AVR between 1995 and 2010. Early and long–term outcomes, such as incidence of congestive heart failure and mortality rate from all causes and from cardiac events were compared between patients with preoperative ejection fraction (EF) <40% and those with preoperative EF>40%. In patients with preoperative EF<40%, chronological changes in LV end–diastolic diameter (LVDd) and EF after AVR were evaluated.
Preoperative EF was <40% in 20 patients (group A) and >40% in 60 patients (group B). The incidence of congestive heart failure early after AVR was higher in group A than group B (45% vs 3%, p<0.001), and 1 patient died of heart failure early after AVR. In group A, LVDd, but not EF improved 1 week after AVR, however, EF improved and became almost normal 1 year after AVR (pre–operative/ 1week after operation/ 1year after operation: LVDd; 72±8mm/ 62±9mm/ 50±8mm, EF; 33±7%/ 35±13%/ 64±10%). Recurrence of LV dysfunction was detected in 5 patients in groupA at 5 years after AVR. 5–year survival rate was significantly lower in groupA than groupB (65% vs 90%, p<0.001) despite EF was once normalized 1 year after AVR.
In patients with severe chronic AR and low EF, EF did not improve early after AVR, but was almost normalized 1 year after AVR. However, recurrence of LV dysfunction was detected, and long–term mortality rate was higher in patients with preoperative low EF. Therefore, long–term follow–up and managements are important after AVR in patients with severe chronic AR and low EF, even if EF was once normalized.
Moderated Poster Contributions
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.–10:30 a.m.
Session Title: Valvular Heart Disease: Clinical IV – Aortic Valve Disease
Abstract Category: 31. Valvular Heart Disease: Clinical
Presentation Number: 1197M–85
- 2013 American College of Cardiology Foundation