Pre- and Postoperative Predictors of Long-Term Prognosis After Aortic Valve Replacement for Severe Chronic Aortic Regurgitation

Circ J. 2016 Nov 25;80(12):2460-2467. doi: 10.1253/circj.CJ-16-0782. Epub 2016 Nov 9.

Abstract

Background: There are few data on the long-term prognosis and chronological changes in left ventricular (LV) function after aortic valve replacement (AVR) in patients with severe chronic aortic regurgitation (AR) among the Japanese population.Methods and Results:We retrospectively investigated the long-term prognosis in 80 consecutive patients with severe chronic AR who underwent AVR. Additionally, 65 patients with follow-up echocardiography at 1 year after AVR were investigated to evaluate chronological changes in LV function. The mean follow-up period was 8.9±5.2 years. Freedom from all-cause death and cardiac death at 10 years after AVR was 76% and 91%, respectively. The preoperative ejection fraction (EF) and estimated glomerular filtration rate were independent predictors of all-cause death. Preoperative EF, LV end-systolic diameter, and diabetes might be useful predictors of cardiac death. Among the 65 patients with follow-up echocardiographic data, LV function had normalized at 1 year after AVR in all patients, except for 2 who died of cardiac causes in the long-term after AVR. LV end-diastolic diameter, LV end-systolic diameter, and EF at 1 year after AVR might be useful predictors of long-term cardiac death.

Conclusions: In patients with severe chronic AR, preoperative LV dysfunction is remarkably improved at 1 year after AVR. Pre- and postoperative echocardiographic data are important for predicting long-term outcome after AVR. (Circ J 2016; 80: 2460-2467).

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aortic Valve Insufficiency* / mortality
  • Aortic Valve Insufficiency* / physiopathology
  • Aortic Valve Insufficiency* / surgery
  • Aortic Valve* / physiopathology
  • Aortic Valve* / surgery
  • Chronic Disease
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis Implantation*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Period
  • Preoperative Period
  • Stroke Volume*
  • Ventricular Function, Left*