Related Experiment Video

Updated: Mar 26, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

14.9K

Aortic valve surgery and survival in patients with moderate or severe aortic stenosis and left ventricular

Zainab Samad1, Amit N Vora2, Allison Dunning3

  • 1Division of Cardiology, Duke Medicine, Duke University, PO Box 3254, Rm 3347A Duke South, 200 Trent Drive, Durham, NC, USA zainab.samad@dm.duke.edu.

European Heart Journal
|January 21, 2016
PubMed

Insights

Aortic valve surgery (AVR) with or without coronary artery bypass grafting (CABG) significantly improves survival in patients with moderate/severe aortic stenosis (AS) and left ventricular systolic dysfunction (LVSD). This intervention offers better outcomes compared to medical therapy or CABG alone.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Echocardiography

Background:

  • Moderate/severe aortic stenosis (AS) with left ventricular systolic dysfunction (LVSD) presents a significant mortality risk.
  • Current treatment strategies and survival outcomes for this patient group require further investigation.

Purpose of the Study:

  • To determine the frequency of aortic valve surgery (AVR) in patients with moderate/severe AS and LVSD.
  • To evaluate the relationship between AVR (with or without CABG) and survival in this cohort.

Main Methods:

  • Retrospective analysis of the Duke Echocardiographic Database (1995-2014) including 132,804 patients.
  • Identification of 1634 patients with moderate/severe AS and LVSD based on echocardiographic criteria.
  • Multivariable Cox models and inverse probability weighting were used to assess AVR's impact on all-cause mortality.

Main Results:

  • AVR was performed in 26% of moderate AS and 48% of severe AS patients within 5 years.
  • Overall, 53% of patients experienced mortality within 5 years post-index echocardiogram.
  • AVR, with or without CABG, was associated with significantly lower 5-year mortality (HR=0.49) compared to medical therapy.
  • CABG plus AVR showed superior survival compared to CABG alone (HR=0.18).

Conclusions:

  • In patients with moderate/severe AS and LVSD, AVR with or without CABG is linked to improved survival.
  • Further research is needed to understand practice patterns and the role of transcatheter approaches in this high-risk population.
Abstract

Keywords:
Moderate aortic stenosisaortic valve surgeryleft ventricular systolic dysfunctionsevere aortic stenosissurvival

More Related Videos

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

12.0K
Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

12.4K

Related Concept Videos

Aortic Regurgitation III: Medical Management01:25

Aortic Regurgitation III: Medical Management

Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
548
Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
441
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
863
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
422
Mitral Stenosis IV: Nursing Management01:27

Mitral Stenosis IV: Nursing Management

A comprehensive nursing assessment is essential for patients with valvular heart disease, which involves any dysfunction of the heart valves that could impact blood flow and overall heart function.Subjective Data Collection:Chief Complaint and Present Illness: Start with the patient's primary concerns, focusing on the onset, duration, and progression of cardiac symptoms such as dyspnea, fatigue, chest pain, and palpitations.Past Medical History: Collect detailed information on any previous...
367
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.3K