[Prevalence and evolution of left ventricular insufficiency in patients undergoing severe aortic insufficiency]

Aortic insufficiency (AR) evolves during follow-up with dilation of the left chambers and eventually with deterioration of the ejection fraction (EF). Treatment as well as evolution of EF after the procedure remains uncertain. The objective of the following work was to establish the prevalence of ventricular dysfunction and evaluate the evolution of EF at 6 months in patients with aortic valve replacement (AVR) due to AR.

A retrospective, descriptive, observational, single-center cohort study was carried out from 1/1/2012 to 12/31/2022. All patients undergoing AVR for severe AR were included. The proportion of patients operated on with EF less than 55%, and their evolution within the first 6 months, were calculated and its evolution within the first 6 months according to the protocol. Recovery was defined as an increase of 10% compared to the pre-surgical EF.

Of 685 patients, 74 had severe AR of which. 4.6% (n= 32) underwent AVR with EF< 55%. The median presurgical EF was 50% [IQR 43.6-53]. At 6 months, 45% (n=11) met recovery criteria with a median EF of 64% (compared to 52% in the group without recovery, p=0.01). In-hospital mortality was 6.2%; 24 of the 32 patients completed follow-up.

The percentage of patients with AR who undergo surgery with left ventricular dysfunction is approximately 50%. In our study 45% had an improvement in ejection fraction at 6 months.