Outcome of cardiac surgery for XXXX .

@entity1 @entity712 @entity409 @entity27954 @entity1130 @entity86 @entity4303 @entity299 @entity3 @entity67 @entity204
OBJECTIVES: The hypothesis was that cardiac surgery for symptomatic @entity299 in conjunction with adjunctive therapy could improve the long-term outlook of @entity1 with @entity299 . BACKGROUND: @entity1 with @entity299 have a dismal prognosis; most die of progressive @entity712 within 1 year after onset of symptoms. Improved therapies for the systemic manifestations of the @entity4303 have resulted in symptomatic improvement and prolonged survival in @entity1 without @entity299 . METHODS: Twenty-six @entity1 with symptomatic @entity299 underwent valvular surgery. Preoperative clinical, laboratory, Doppler echocardiographic and hemodynamic factors were evaluated. The survival of the surgical group was compared with that of a control group of 40 medically treated @entity1 . RESULTS: There were nine perioperative @entity204 (35%), primarily from @entity86 and @entity67 . Of the 17 surgical survivors, 8 were alive at a mean of 28 months of follow-up. The postoperative functional class of the eight surviving @entity1 was substantially improved. Late @entity204 were primarily due to @entity409 caused by @entity3 . The only predictor of operative mortality (p = 0.03) was low voltage on preoperative electrocardiography (limb lead voltage < or = 5 mm). Predictors of late survival included a lower preoperative somatostatin requirement and a lower preoperative urinary @entity1130 level. There was a trend toward increased survival for the surgical group compared with the control group. CONCLUSIONS: Because new therapies have improved survival in @entity1 with the @entity27954 , @entity299 has become a major cause of morbidity and mortality. Valve surgery is the only definitive treatment. Although cardiac surgery carries a high perioperative mortality, marked symptomatic improvement occurs in survivors. Surgical intervention should therefore be considered when cardiac symptoms become severe.
