PMID: 8606280Mar 1, 1996Paper

Aortic regurgitation complicated by extreme left ventricular dilation: long-term outcome after surgical correction

Journal of the American College of Cardiology
E KlodasJ B Seward

Abstract

This study sought to determine the outcome of aortic valve replacement for aortic regurgitation complicated by extreme left ventricular dilation. Aortic valve replacement has been recommended in aortic regurgitation with extreme left ventricular dilation (diastolic dimension >/= 80 mm), but extreme left ventricular dilation raises concern about irreversible left ventricular dysfunction. Thirty-one patients with a preoperative echocardiographic diastolic dimension >/= 80 mm (group 1) undergoing operation for severe isolated aortic regurgitation between 1980 and 1989 were compared with 188 patients with a diastolic dimension <80 mm operated on during the same period (group 2). Preoperatively, extreme left ventricular dilation was seen only in male patients and was associated with a reduced ejection fraction (43 +/- 12% vs. 53 +/- 11% [mean +/- SD], p < 0.0001). The postoperative outcome of group 1 was compared with that of male patients in group 2 (group 2M, n = 144). The operative mortality rates for groups 1 and 2M were 0% and 5.6%, respectively (p = 0.35). Late survival in operative survivors was similar in groups 1 and 2M, but compared with expected survival, an excess mortality was observed for group 1 (p = 0.024). Preoperat...Continue Reading

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Citations

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