Background. Optimal management for patients with severe aortic stenosis (AS) and left ventricular (LV) dysfunction is not well defined. Previous study results of aortic valve replacement in these patients have been variable. This study reports surgical experience and follow-up results of patients with severe AS and LV dysfunction who have undergone aortic valve replacement here during the past six years. Methods. The records of eight patients, aged 57-78 years (mean 70), with severe AS and LV dysfunction (ejection fraction ≤ 0.45) were reviewed to assess the prognosis after aortic valve replacement had been done between September 1988 and November 1994. All these patients underwent hemodynamic evaluation by echocardiography preoperatively and postoperatively. Results. There was no operative death or late mortality. The mean follow-up period was 28 ± 19 months (ranged 2 to 66). Of these eight patients, four were initially in New York Heart Association (NYHA) functional class IV, two were in class III and the remaining two were in class II; currently six are in class I and two, in class II. The cardiothoracic ratio on chest x-ray film decreased from 0.66 ± 0.08 to 0.57 ± 0.05 (p < 0.05). The aortic valve pressure gradient decreased from 123 ± 45 to 20 ± 12 mmHg. The left ventricular end-diastolic volume index decreased from 108 ± 24 to 71 ± 23 ml/m2 (p < 0.05), the left ventricular endsystolic volume index decreased from 69 ± 20 to 26 ± 12 ml/m2 (p < 0.001), and the left ventricular ejection fraction increased dramatically from 0.36 ± 0.09 to 0.64 ± 0.07 (p < 0.001). Conclusion. The encouraging surgical and long-term survival, improved functional class and marked improvement in LV function that occurred in our patients indicate that, for patients with severe AS and depressed LV function in clinical heart failure, undergoing aortic valve replacement should be recommended.
|頁（從 - 到）||63-68|
|期刊||Acta Cardiologica Sinica|
|出版狀態||Published - 1995|
All Science Journal Classification (ASJC) codes