Abstract
Forty-five patients underwent aortic valve replacement (AVR) for severe isolated aortic regurgitation from 1973 to 1979. There were two (4.4%) hospital deaths, both functional class IV. Six patients with mechanical prosthesis not receiving anticoagulants were excluded from further analysis. These data relate to 39 patients; the two operative deaths, 35 patients with mechanical prosthesis receiving anticoagulants, and two with bioprosthesis. There were three late cardiac deaths with 5-year survival 85%; average annual mortality rate of 3%. The 5-year survival with pre-AVR left ventricular (LV) ejection fraction ≥ 0.45 was 87% vs 54% <0.45, (p <0.04); cardiac index ≥ 2.5 L/min/m2 92% vs 66% <2.5 (p <0.04); mean VCF ≥ 0.75 vs <0.75 circ/sec (p <0.09); end-diastolic pressure ≤ 20 vs > 20 mm Hg (p <0.08). Late survival was not significantly different between pre-AVR functional class I and II vs class III and IV; LV end-diastolic volume index ≥ 210 vs <210 ml/m2; LV end-systolic volume index ≥ 110 vs <110 ml/m2; and LV mass ≥ 240 vs <240 gm/m2. With ejection fraction ≥ 0.50 there was only one operative death (functional class IV) and no late cardiac deaths. Thus late survival following aortic valve replacement for severe isolated aortic regurgitation is better predicted preoperatively by the LV systolic pump function variables of ejection fraction and cardiac index than by LV diastolic parameters and clinical status.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 300-308 |
| Number of pages | 9 |
| Journal | American Heart Journal |
| Volume | 101 |
| Issue number | 3 |
| DOIs | |
| State | Published - 1981 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Preoperative criteria predictive of late survival following valve replacement for severe aortic regurgitation. / Greves, John; Rahimtoola, Shahbudin H.; McAnulty, John H.; DeMots, Henry; Clark, David G.; Greenberg, Barry; Starr, Albert.
In: American Heart Journal, Vol. 101, No. 3, 1981, p. 300-308.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preoperative criteria predictive of late survival following valve replacement for severe aortic regurgitation
AU - Greves, John
AU - Rahimtoola, Shahbudin H.
AU - McAnulty, John H.
AU - DeMots, Henry
AU - Clark, David G.
AU - Greenberg, Barry
AU - Starr, Albert
PY - 1981
Y1 - 1981
N2 - Forty-five patients underwent aortic valve replacement (AVR) for severe isolated aortic regurgitation from 1973 to 1979. There were two (4.4%) hospital deaths, both functional class IV. Six patients with mechanical prosthesis not receiving anticoagulants were excluded from further analysis. These data relate to 39 patients; the two operative deaths, 35 patients with mechanical prosthesis receiving anticoagulants, and two with bioprosthesis. There were three late cardiac deaths with 5-year survival 85%; average annual mortality rate of 3%. The 5-year survival with pre-AVR left ventricular (LV) ejection fraction ≥ 0.45 was 87% vs 54% <0.45, (p <0.04); cardiac index ≥ 2.5 L/min/m2 92% vs 66% <2.5 (p <0.04); mean VCF ≥ 0.75 vs <0.75 circ/sec (p <0.09); end-diastolic pressure ≤ 20 vs > 20 mm Hg (p <0.08). Late survival was not significantly different between pre-AVR functional class I and II vs class III and IV; LV end-diastolic volume index ≥ 210 vs <210 ml/m2; LV end-systolic volume index ≥ 110 vs <110 ml/m2; and LV mass ≥ 240 vs <240 gm/m2. With ejection fraction ≥ 0.50 there was only one operative death (functional class IV) and no late cardiac deaths. Thus late survival following aortic valve replacement for severe isolated aortic regurgitation is better predicted preoperatively by the LV systolic pump function variables of ejection fraction and cardiac index than by LV diastolic parameters and clinical status.
AB - Forty-five patients underwent aortic valve replacement (AVR) for severe isolated aortic regurgitation from 1973 to 1979. There were two (4.4%) hospital deaths, both functional class IV. Six patients with mechanical prosthesis not receiving anticoagulants were excluded from further analysis. These data relate to 39 patients; the two operative deaths, 35 patients with mechanical prosthesis receiving anticoagulants, and two with bioprosthesis. There were three late cardiac deaths with 5-year survival 85%; average annual mortality rate of 3%. The 5-year survival with pre-AVR left ventricular (LV) ejection fraction ≥ 0.45 was 87% vs 54% <0.45, (p <0.04); cardiac index ≥ 2.5 L/min/m2 92% vs 66% <2.5 (p <0.04); mean VCF ≥ 0.75 vs <0.75 circ/sec (p <0.09); end-diastolic pressure ≤ 20 vs > 20 mm Hg (p <0.08). Late survival was not significantly different between pre-AVR functional class I and II vs class III and IV; LV end-diastolic volume index ≥ 210 vs <210 ml/m2; LV end-systolic volume index ≥ 110 vs <110 ml/m2; and LV mass ≥ 240 vs <240 gm/m2. With ejection fraction ≥ 0.50 there was only one operative death (functional class IV) and no late cardiac deaths. Thus late survival following aortic valve replacement for severe isolated aortic regurgitation is better predicted preoperatively by the LV systolic pump function variables of ejection fraction and cardiac index than by LV diastolic parameters and clinical status.
UR - http://www.scopus.com/inward/record.url?scp=0019504106&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0019504106&partnerID=8YFLogxK
U2 - 10.1016/0002-8703(81)90194-0
DO - 10.1016/0002-8703(81)90194-0
M3 - Article
C2 - 6451163
AN - SCOPUS:0019504106
VL - 101
SP - 300
EP - 308
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 3
ER -