https://scholars.lib.ntu.edu.tw/handle/123456789/523214
標題: | Valvular replacement for patients with aortic stenosis and severe left ventricular dysfunction | 作者: | Liu C.-P. RON-BIN HSU Hua S.-Z. YI-LWUN HO |
公開日期: | 2005 | 卷: | 21 | 期: | 1 | 起(迄)頁: | 21-27 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Background and Purpose: The 2-year survival of patients with aortic stenosis (AS) and congestive heart failure is less than 10% under medical treatment. On the other hand, the surgical risk of aortic valve replacement (AVR) also increases for patients with AS and severe left ventricular (LV) dysfunction. The aim of this study was to evaluate the risk and benefit of AVR for such patients. Methods: From May 1999 to April 2003, 8 consecutive patients with AS and severe LV dysfunction (ejection fraction [EF] ? 30%) underwent aortic valve replacement in National Taiwan University Hospital. The myocardial protection was initially achieved with antegrade perfusion and maintained with continuous retrograde cold blood or crystalloid cardioplegia. The indication for aortic valve replacement was severe AS, which was defined as an aortic valve area of ? 1.0 cm2 or a maximum pressure gradient of ? 50 mmHg assessed by Doppler echocardiography. The mean age was 67 ± 9 years; and 7 of 8 patients suffered from severe exertional dyspnea (functional class III-IV of New York Heart Association). Respiratory failure developed in 5 patients prior to surgery. Results: The perioperative (30-day) mortality was 0%. During a mean follow-up period of 32 ± 18 months (range 16-61 months), the survival rate was 75%. The clinical symptoms of heart failure improved at least one functional class in all patients. The mean change of LVEF was an increase of 26 ± 18 EF units (p = 0.005), and the mean reductions of LV end-systolic dimension and LV end-diastolic dimension were 16 ± 8 (p = 0.001) and 11 ± 8 mm (p = 0.005), respectively. Conclusions: The surgical risk was acceptable for AVR in patients with AS and severe LV dysfunction. Improvements in symptoms, heart size and LV systolic function were observed in most patients. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-20844432705&partnerID=40&md5=608b8215e5ec74880854345b020de9ec https://scholars.lib.ntu.edu.tw/handle/123456789/523214 |
ISSN: | 1011-6842 | SDG/關鍵字: | adult; aged; aorta stenosis; aorta valve replacement; article; bioprosthesis; cardioplegia; clinical article; disease course; Doppler echocardiography; dyspnea; female; heart ejection fraction; heart left ventricle failure; heart perfusion; heart protection; human; male; respiratory failure; surgical risk; survival rate; treatment outcome |
顯示於: | 醫學系 |
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