Valve replacement for aortic regurgitation resulted in 58% survival at 5-9 years, with preoperative evidence of left ventricular failure strongly predicting postoperative death from myocardial failure.
Cohort (n=100)
One hundred consecutive cases of valve replacement for aortic regurgitation performed between 1967--1971 were analyzed to identify and quantitate factors related to a favorable result. Of 83 perioperative survivors, 78% (n = 65) became asymptomatic and 58% (n = 48) were alive 5--9 years postoperatively. The cause of aortic regurgitation affected both the speed of progression of symptoms and the postoperative result. Death due to myocardial failure may be prevented by optimal timing of operation. Accordingly, we identified variables that discriminated between patients who had an excellent postoperative result and those who died of myocardial failure. The most important discriminators were the severity (p = 0.03) and duration (p = 0.04) of dyspnea, the extent of therapy for heart failure (p = 0.001), physical findings of left ventricular failure (p = 0.002), the cardiothoracic ratio (p = 0.007), the resting pulmonary capillary wedge pressure (p = 0.01), and a cardiac index less than 2.2 1/min/m2 (p = 0.03). The data suggest that evidence of left ventricular failure, even of mild degree, is an indication for operation in patients with severe aortic regurgitation.
Samuels et al. (Sat,) conducted a cohort in Aortic regurgitation (n=100). Valve replacement was evaluated on Survival and asymptomatic status at 5-9 years postoperatively. Valve replacement for aortic regurgitation resulted in 58% survival at 5-9 years, with preoperative evidence of left ventricular failure strongly predicting postoperative death from myocardial failure.
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