Key result
Aortic valve replacement is indicated in severe rheumatic aortic regurgitation when the cardiothoracic ratio is >0.60 or heart failure is present with extreme left ventricular hypertrophy.
Why the study?
What clinical and haemodynamic factors are associated with adverse outcomes and indicate the need for surgery in patients with severe rheumatic aortic regurgitation?
Population
180 patients with severe aortic regurgitation of rheumatic origin
Comparison
Aortic valve replacement (n=110) vs Natural history / no surgery (n=70)
Design
Cohort
Authors
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Supports surgical timing in severe rheumatic AR with CTR >0.60 or HF plus extreme LVH; leaves open prospective validation.
Cohort (n=180)
What clinical and haemodynamic factors are associated with adverse outcomes and indicate the need for surgery in patients with severe rheumatic aortic regurgitation?
In severe rheumatic aortic regurgitation, surgery is indicated for a cardiothoracic ratio >0.60 or heart failure with extreme left ventricular hypertrophy, and may be safely postponed if these are absent.
Smith et al. (1976) conducted a cohort in severe aortic regurgitation of rheumatic origin (n=180). Aortic valve replacement vs. Natural history (no surgery) was evaluated on Death before surgery, surgical complications and hospital mortality, and unsatisfactory longer-term result. Aortic valve replacement is indicated in severe rheumatic aortic regurgitation when the cardiothoracic ratio is >0.60 or heart failure is present with extreme left ventricular hypertrophy.
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