What question did this study set out to answer?

To examine the relationship between preoperative patient status and cardiac pathology observed in autopsy after valve replacement for aortic stenosis.

January 1, 1989Scandinavian Journal of Thoracic and Cardiovascular Surgery

Cardiac Pathology After Isolated Valve Replacement for Aortic Stenosis in Relation to Preoperative Patient Status:Early and Late Autopsy Findings

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Aortic stenosis (n=51). Intervention: Isolated valve replacement. Primary outcome: Cardiac pathology at autopsy (Heart weight index, left ventricular wall thickness, scattered streaky fibrosis, circumscript fibrotic scars, coronary artery disease).

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Key result

Isolated valve replacement for aortic stenosis was associated with residual left ventricular hypertrophy in 86% of autopsied cases, emphasizing the need for early operative intervention.

Population

51 patients who underwent isolated valve replacement for aortic stenosis between 1965-1973 and died 0 days…

Design

Cohort

Follow-up

0 days to 14 years (mean 3.2 years)

Authors

OLOle LundSemmelweis University KLKnud Erik LarsenAarhus University

Discussion

Member takes

Implication

Residual LVH after AVR for AS may signal irreversible damage; leaves open optimal intervention timing in prospective trials.

Key Points

To examine the relationship between preoperative patient status and cardiac pathology observed in autopsy after valve replacement for aortic stenosis.
Autopsy performed on 51 out of 79 patients who underwent valve replacement for aortic stenosis.
Multiple regression analyses conducted to identify predictive factors of autopsy findings.
Parameters measured included heart weight index (HWI), left ventricular wall thickness (LVWT), and signs of fibrosis and coronary artery disease.
Average HWI was 356 +/- 94 g/m2, with 86% showing left ventricular hypertrophy.
Moderate/severe coronary artery disease found in 33%; fibrosis patterns were unrelated to CAD.
Predictive factors for cardiac findings included left ventricular failure and transvalvular peak-systolic gradient.

Study Design

Type

Observational (n=51)

Structured PICO

Population

51 patients (out of a cohort of 79) who underwent isolated valve replacement for aortic stenosis between 1965-1973 and died 0 days to 14 years (mean 3.2 years) later and underwent autopsy.

Intervention

Isolated valve replacement for aortic stenosis

Outcome

Cardiac pathology at autopsy (heart weight index, left ventricular wall thickness, scattered streaky fibrosis, circumscript fibrotic scars, coronary artery disease) and its relation to preoperative patient statussurrogate

Autopsy findings up to 14 years after valve replacement for aortic stenosis demonstrate persistent, irreversible myocardial damage that correlates with preoperative functional status, supporting early operative intervention.

Cite This Study

Lund et al. (1989) conducted an observational in Aortic stenosis (n=51). Isolated valve replacement was evaluated on Cardiac pathology at autopsy (Heart weight index, left ventricular wall thickness, scattered streaky fibrosis, circumscript fibrotic scars, coronary artery disease). Isolated valve replacement for aortic stenosis was associated with residual left ventricular hypertrophy in 86% of autopsied cases, emphasizing the need for early operative intervention.

synapsesocial.com/papers/6a082762ab15ea61dee8b18d https://doi.org/10.3109/14017438909106006

Topics

Cardiomyopathy

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Cardiac Pathology After Isolated Valve Replacement for Aortic Stenosis in Relation to Preoperative Patient Status:Early and Late Autopsy Findings

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Cardiac Pathology After Isolated Valve Replacement for Aortic Stenosis in Relation to Preoperative Patient Status:Early and Late Autopsy Findings

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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Topics

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