Outcomes After Aortic Valve Replacement for Asymptomatic Severe Aortic Regurgitation and Normal Ejection Fraction.
We investigated long-term outcomes following aortic valve replacement (AVR) in asymptomatic patients with severe aortic regurgitation (AR) and normal left ventricular (LV) function. We reviewed 268 patients who underwent isolated AVR for chronic severe AR from 1991 to 2010 and enrolled 162 asymptomatic patients with normal LV ejection fraction (≥50%) preoperatively. They were divided into 2 groups according to LV dimension at surgery, the early stage C group (indexed LV end-systolic diameter ≤25 mm/m2 and LV end-diastolic diameter ≤65 mm, n = 61), and late stage C group (indexed LV end-systolic diameter >25 mm/m2 and/or LV end-diastolic diameter >65 mm, n = 101). Survival was compared with that of an age- and gender-matched Japanese general population using a one-sample log-rank test. Subgroup analysis was performed for patients who survived >10 years after AVR. The mean age of all patients was 59 ± 14 years and mean follow-up period was 10 ± 5 years. Survival after AVR for the early and late stage C groups was not statistically different (P = 0.57). Furthermore, survival for both groups was not statistically different from that of the general population (early stage C, P = 0.63; late stage C, P = 0.14). However, subgroup analysis showed that survival >10 years after AVR was significantly worse for the late stage C group as compared to that of the general population (P < 0.001). Long-term survival following AVR for asymptomatic AR with normal LV ejection fraction was excellent. However, survival more than 10 years after surgery might be dependent on LV dimension at surgery.
['Maeda|Shusaku|S|', 'Taniguchi|Kazuhiro|K|', 'Toda|Koichi|K|', 'Funatsu|Toshihiro|T|', 'Kondoh|Haruhiko|H|', 'Yokota|Takenori|T|', 'Kainuma|Satoshi|S|', 'Daimon|Takashi|T|', 'Yoshikawa|Yasushi|Y|', 'Sawa|Yoshiki|Y|', '|||']
D000328:Adult D000368:Aged D001021:Aortic Valve D001022:Aortic Valve Insufficiency D058070:Asymptomatic Diseases D019917:Blood Vessel Prosthesis Implantation D005260:Female D006350:Heart Valve Prosthesis D006439:Hemodynamics D006801:Humans D007564:Japan D008297:Male D008875:Middle Aged D020127:Recovery of Function D012189:Retrospective Studies D012307:Risk Factors D012720:Severity of Illness Index D013318:Stroke Volume D013997:Time Factors D016896:Treatment Outcome D016277:Ventricular Function, Left
Aortic valve replacement Survival Aortic insufficiency Clinical outcome