Related Experiment Videos
Heart failure after aortic valve replacement for aortic regurgitation: prospective 20-year study
M P Tornos1, M Olona, G Permanyer-Miralda
1Servei de Cardiologia, Hospital General Universitari Vall d'Hebron, Barcelona, Spain.
American Heart Journal
|October 20, 1998
Summary
Patients undergoing aortic valve replacement for aortic regurgitation face a significant risk of heart failure post-surgery. Age over 50 is a key predictor for both heart failure and death, highlighting the need for careful preoperative assessment.
Area of Science:
- Cardiology
- Cardiac Surgery
- Heart Failure Research
Background:
- Aortic regurgitation (AR) necessitates aortic valve replacement (AVR) to prevent heart failure.
- Preoperative patient factors are crucial for predicting long-term outcomes after AVR.
Purpose of the Study:
- To evaluate the long-term probability of developing heart failure after AVR for AR.
- To identify preoperative predictors of heart failure and mortality post-AVR.
Main Methods:
- Prospective follow-up of 87 patients with pure AR undergoing AVR.
- Clinical assessment, echocardiography, and radionuclide ejection fraction measured preoperatively and up to 10 years post-AVR.
Main Results:
- Operative mortality was 2.2%. Overall survival was 87% at 5 years and 81% at 10 years.
- Heart failure developed in 16% of patients by 5 years and 24% by 10 years.
- Independent predictors for heart failure included age >50, ejection fraction <40%, and end-systolic diameter >50 mm.
Conclusions:
- AVR is a safe procedure for severe AR when current guidelines are followed.
- Age >50, end-systolic diameter >50 mm, and ejection fraction <40% predict postoperative heart failure.
- Age >50 is the sole independent predictor for both postoperative death and heart failure.