Late survival after valve operation in patients with left ventricular dysfunction
| Autor: | Andrzej S. Kosinski, John Parker Gott, Ellis L. Jones, Charles O. Murphy, Robert A. Guyton, Joseph M. Craver, Ignacio G Duarte |
|---|---|
| Rok vydání: | 1997 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male medicine.medical_specialty Heart disease Adolescent Heart Valve Diseases Ventricular Dysfunction Left Risk Factors Mitral valve Internal medicine medicine Humans Hospital Mortality Survivors Coronary Artery Bypass Survival analysis Aged Aged 80 and over Heart Valve Prosthesis Implantation Mitral regurgitation Ejection fraction business.industry Middle Aged medicine.disease Survival Analysis Surgery medicine.anatomical_structure Logistic Models Concomitant Aortic Valve cardiovascular system Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Artery Follow-Up Studies |
| Zdroj: | The Annals of thoracic surgery. 64(4) |
| ISSN: | 0003-4975 |
| Popis: | Left ventricular dysfunction is a predictor of hospital mortality after cardiac valve operation. We evaluated late survival in a large cohort of these patients.From 1980 to 1993, 257 patients with a preoperative ejection fraction of 0.40 or less underwent aortic (n = 177), mitral (n = 72), or combined (n = 8) valve operation, with or without concomitant coronary artery bypass grafting.Hospital mortality was 12.5%. Follow-up was 98% complete. Logistic regression analysis showed that an ejection fraction of less than 0.30, mitral regurgitation, concomitant coronary artery bypass grafting, emergency operation, and reoperation were independent correlates of hospital mortality (all at p0.05). Kaplan-Meier survival curves of the 220 hospital survivors showed a 65% 5-year survival. Multivariate analysis revealed preoperative use of diuretics, male sex, reoperation, age exceeding 60 years, and aortic regurgitation to be independent predictors of poor late outcome (all at p0.05).The liability of left ventricular dysfunction with regard to diminished long-term survival is not completely reversed by valve operation. If operation is not performed before left ventricular dysfunction develops, postoperative medical treatment of these dilated, remodeled ventricles should be considered. |
| Databáze: | OpenAIRE |
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