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Related Experiment Videos

Aortic valve replacement in patients with impaired ventricular function.

Ram Sharony1, Eugene A Grossi, Paul C Saunders

  • 1Division of Cardiothoracic Surgery, Department of Surgery, New York University School of Medicine, New York, New York, USA.

The Annals of Thoracic Surgery
|June 26, 2003
PubMed
Summary

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Aortic valve surgery in patients with reduced ventricular function has acceptable risks. Age and comorbidities, not valve disease type, predict mortality, enabling risk stratification for improved patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery Outcomes
  • Valvular Heart Disease

Background:

  • Patients with reduced ventricular function undergoing aortic valve replacement face increased operative risks.
  • The specific impact of valvular pathophysiology and other risk factors on outcomes remains unclear.

Purpose of the Study:

  • To define the impact of valvular pathophysiology and comorbidities on operative risks in patients with reduced ventricular function undergoing aortic valve replacement.
  • To identify predictors of mortality and postoperative complications in this patient cohort.

Main Methods:

  • A retrospective analysis of 1,402 consecutive patients undergoing isolated aortic valve surgery (1992-2002).
  • Focus on 416 patients with ejection fraction < 40%, analyzing demographics, valvular disease type (stenosis, regurgitation, mixed), comorbidities, and surgical procedures.

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  • Utilized echocardiography and survival analysis for follow-up and risk factor assessment.

    • Main Results:

    • Hospital mortality was 10.1%, with no significant difference between aortic stenosis and regurgitation.
    • Independent predictors of mortality included advanced age and renal disease.
    • Peripheral vascular disease, cerebrovascular disease history, and diabetes were associated with increased risk of postoperative complications and stroke.

    Conclusions:

    • Aortic valve surgery in patients with impaired ventricular function presents an acceptable operative risk.
    • Risk stratification is feasible using patient age and comorbidities.
    • The specific type of valvular pathophysiology does not significantly influence mortality outcomes.