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From 1965 through 1986 136 patients underwent valve replacement for aortic regurgitation. Mean age was 50 years and male:female ratio 3.7:1. Hospital mortality (HM, less than or equal to 30 days) varied with NYHA classes and digitalis/diuretics treatment (D/D):I (n = 80) 0%, II without D/D (n = 17) 0%, II with D/D (n = 21) 5%, III (n = 55) 7%; and IV (n = 35) 29% (p less than 0.01). Long-term survival was examined for 121 patients who were alive 30 days postoperatively. Five- and 10-year cumulative survival +/- SE were 80 +/- 4% and 66 +/- 6%, respectively. No late deaths were noted for NYHA class I and NYHA class II without D/D; NYHA class II with D/D had survival characteristics comparable to NYHA class III with 10-year survivals of 60%. Patients with acute regurgitation (endocarditis, n = 35) had a 10-year survival +/- SE of 88 +/- 5% compared to 57 +/- 7% for chronic regurgitation (p = 0.05). A Cox regression analysis revealed that ventricular ectopic beats, chronic regurgitation, left ventricular failure, and right ventricular failure were independent risk factors. Presence and different combination of these risk factors identified 5 risk groups (A-E) with 10-year survivals of:A (n = 16) 100%; B (n = 50) 75%; C (n = 37) 63%; D (n = 15) 27%; and E (n = 3) 0% (p less than 0.0001). Minimally symptomatic patients without preoperative medical treatment for congestive heart failure had superior survival characteristics compared to those who received treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Pilegaard et al. (Tue,) studied this question.