Why the study?
AVR for chronic AR with reduced LVEF carries greater surgical risk, and long-term outcomes remain poorly described in contemporary cohorts.
Does aortic valve surgery in patients with chronic severe aortic regurgitation and severely reduced LVEF (<35%) result in similar operative mortality and long-term outcomes compared to those with mild to moderately reduced LVEF (35-50%)?
Does aortic valve surgery in patients with chronic severe aortic regurgitation and severely reduced LVEF (<35%) result in similar operative mortality and long-term outcomes compared to those with mild to moderately reduced LVEF (35-50%)?
Aortic valve replacement for chronic severe aortic regurgitation in patients with severely reduced LVEF (<35%) is safe and associated with favorable long-term outcomes and reverse remodeling when combined with optimal medical therapy.
Background: Aortic valve replacement (AVR) for chronic aortic regurgitation (AR) in the presence of reduced left ventricular ejection fraction (LVEF) is associated with greater surgical risk. Long-term outcomes remain poorly described in contemporary cohorts. Methods: Between 2004 and 2019, 122 patients underwent AVR for chronic severe AR with LVEF < 50%. Patients with severely reduced LVEF (< 35%; n = 37) were compared with those with mild to moderately reduced LVEF (35%-50%; n = 85). Conclusions: In this contemporary cohort of patients who underwent AVR for chronic severe AR, patients with severely reduced LVEF treated with optimal medical therapy had operative mortality and freedom from cardiovascular death similar to patients with mild to moderately reduced LVEF. Favourable left ventricular remodelling was observed in both groups. Hospitalization for heart failure was < 15% in both groups at 10-year follow-up.
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Blais et al. (2025) studied this question.
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