Long-term results of aortic valve replacement in patients with severe left ventricular dysfunction

Objective. To study the long-term results of aortic valve replacement in patients with severe left ventricular dysfunction. Material and methods. A retrospective analysis included patients with LV EF ≤30% who underwent aortic valve surgery between January 2005 and January 2021. Inclusion criteria: age >18 years, severe aortic stenosis or insufficiency, LV EF — 30%. Exclusion criteria: redo surgery and any concomitant procedures. Long-term mortality and freedom from stroke, MACE and major bleeding were evaluated. Results. Isolated aortic valve replacement was performed in 3425 patients throughout the follow-up period. Of these, 176 ones were included in the study. Long-term data were available for 160 patients (93% completeness of follow-up). The median follow-up period was 4 years. Ten-year survival was 88%, freedom from stroke — 89%, freedom from MACE — 83%, freedom from major bleeding — 93%. There was positive LV remodeling with significant decrease in linear dimensions and normalization of LV EF after 3 postoperative years. Conclusion. Surgical aortic valve replacement is an effective method for treating patients with isolated aortic valve disease and severe LV dysfunction. This procedure is accompanied by satisfactory survival and low risk of serious complications in long-term period.