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Cardiac valve surgery in patients with poor left ventricular function.

T E David, O Dunin-Bell, S Orr

    Canadian Journal of Surgery. Journal Canadien De Chirurgie
    |March 1, 1983
    PubMed
    Summary

    Surgical correction of valvular heart disease in patients with severely impaired left ventricular function significantly improves symptoms and survival rates. This study demonstrates positive outcomes for high-risk cardiac surgery patients.

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    Area of Science:

    • Cardiology
    • Cardiac Surgery
    • Cardiovascular Medicine

    Background:

    • Severely impaired left ventricular function poses significant risks for patients undergoing valvular heart disease surgery.
    • Patients with ejection fraction <40% and elevated left ventricular end-diastolic pressure often present with advanced New York Heart Association (NYHA) class III or IV symptoms.

    Purpose of the Study:

    • To evaluate the safety and efficacy of surgical intervention for valvular heart disease in patients with severely compromised left ventricular function.
    • To assess the perioperative outcomes and long-term survival in this high-risk patient cohort.

    Main Methods:

    • Retrospective analysis of 41 patients with severely impaired left ventricular function undergoing valvular heart surgery between 1978 and 1981.
    • Surgical correction included valve replacement or repair, with concurrent coronary artery bypass grafting in 22 patients.

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  • Follow-up averaged 26 months, assessing symptomatic improvement and survival.

    • Main Results:

    • Operative mortality was low (3 hospital deaths).
    • Late mortality resulted in an overall actuarial survival of 79% at a mean follow-up of 26 months.
    • All surviving patients experienced at least a one-class improvement in NYHA functional status.

    Conclusions:

    • Surgical correction of valvular heart disease is feasible and beneficial even in patients with severely impaired left ventricular function.
    • Combined valve surgery and coronary revascularization can lead to significant symptomatic improvement and favorable long-term survival.
    • This approach offers a viable treatment option for carefully selected high-risk cardiac patients.