Title: Assesment of results of surgical treatment in patients with aortic valve stenosis and low ejection fraction


Objective: Assesment of results of aortic valve replacement (AVR) in patients with isolated aortic stenosis (AS) and low ejection fraction (LVEF), the prognostic value of EF and other factors of operative risk. Materiał and method: The study group - 126 patients with critical AS and low LVEF <40% (14 - 40%, mean 31 %±7.6), who had been operated on at the Dept. of Cardiovascular Surgery & Transplantology Jagiellonian University between 1990 and 2003. Subjects with LVEF >40% (mean 59% ± 8.9) were matched as controls. Mean age was 57.4 ± 9.5 years, and man were predominated (83%). Total follow-up was 14 years. Results: In the study group 11 % of patients died vs 5.5% in the control group, ns, The cardiogenic shock was the main cause of death. Actuarial 5-year survival was 78%, but 14-year survival was 72%, and did not differ significantly from that in the controls. Within the first year after the AVR, LVEF significantly improved, from 31 % to 52% on average (i.e. almost 150% of mean baseline value to maximum 300%!). Conclusions: The outcome of surgical treatment in patients with isolated AS and low LVEF is good and the operative risk is acceptable. The EF value is not an independent significant risk factor for death and should not be an absolute contraindication for AVR. AVR quickly increases EF, and improves clinical condition of patients. The predictors of poor outcome after A ; VR include myocardial hypertrophy, reduced valvular gradient, bacterial endocarditis, NYHA class, diabetes mellitus, cardiogenic shock and its complications, cerebral emboli and smoking. The cut-off value of low EF is 30%.

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2 - studia doktoranckie

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Wydział Lekarski


Pfitzner, Roman

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Jul 19, 2022

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Nov 21, 2012

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Edition name Date
ZB-103490 Jul 19, 2022


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