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[What effect does impaired left ventricular function have on prognosis following prosthetic aortic valve
Zeitschrift Fur Kardiologie
|September 1, 1986
Summary
For advanced aortic stenosis, prompt valve replacement improves survival, regardless of left ventricular ejection fraction. However, impaired left ventricular function is a poor prognostic factor for aortic insufficiency patients undergoing valve replacement.
Area of Science:
- Cardiology
- Cardiac Surgery
- Clinical Outcomes
Context:
- Retrospective analysis of 286 patients with advanced chronic aortic valve disease (NYHA class III or IV) undergoing aortic valve replacement between 1975 and 1982.
- Preoperative assessment included left ventricular volumes and ejection fraction determined via angiography.
Purpose:
- To investigate the prognostic impact of left ventricular ejection fraction and timing of surgery on survival after aortic valve replacement for aortic stenosis and aortic insufficiency.
- To determine if impaired left ventricular ejection fraction is a risk factor in advanced aortic valve disease.
Summary:
- For aortic stenosis, survival up to 7 years was similar between patients with impaired and normal left ventricular ejection fraction. Early surgery (within 76 days of heart catheterization) correlated with better survival.
- In contrast, for aortic insufficiency, impaired left ventricular ejection fraction was associated with poorer prognosis post-operation compared to those with normal ejection fraction.
Impact:
- Patients with advanced aortic stenosis should undergo timely surgical intervention upon diagnosis.
- Left ventricular dysfunction is identified as a significant risk factor for prognosis in patients with aortic insufficiency undergoing valve replacement, but not for aortic stenosis.