Circulation, Vol 66, 1105-1110, Copyright © 1982 by American Heart Association
F Schwarz, P Baumann, J Manthey, M Hoffmann, G Schuler, HC Mehmel, W Schmitz and W Kubler
We retrospectively studied 252 operated and 47 unoperated patients with
isolated aortic valve disease. Aortic valve replacement (AVR) was
recommended to all patients based on clinical and hemodynamic data.
Preoperative hemodynamic and angiographic data were similar in operated and
unoperated cohorts. Seventy-one percent of patients received a Bjork-Shiley
prosthesis. Operative mortality was 7% for the entire surgical series. For
patients with predominant aortic stenosis (AS), survival at 3 years was 87%
in operated and 21% in unoperated patients (p less than 0.001). For
patients with predominant aortic insufficiency (AI), the 5-year survival
rate was 86% in operated and 87% in unoperated patients (NS). AVR improved
long-term survival in patients with AS who had normal or impaired left
ventricular (LV) function. In patients with AI and normal LV function,
survival was not improved after AVR, but those with LV dysfunction who were
operated on tended to survive longer (NS). Long-term survival of unoperated
patients with AI was better than that in unoperated patients with AS. We
conclude that AVR improves long-term survival in patients with AS who were
normal or abnormal LV function, and that AVR does not change long-term
survival in patients with AI, although those with LV dysfunction tended to
survive longer.
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