OBJECTIVE: The aim of this study was to assess the effects of aortic valve replacement (AVR) on the recovery of left ventricular function and the predictors for long-term survival in @entity1 suffering from isolated severe @entity472 ( @entity472 ) with a significant @entity1002 ( @entity1002 ). METHODS: This retrospective study was conducted on 46 @entity1 with isolated severe @entity472 and @entity1002 [left ventricular ejection fraction (LVEF) = or < 40%] who underwent AVR in our clinic between January 1993 and March 2006. @entity1 with @entity453 , with more than moderate @entity337 (>2), with previous valve replacement or repair, and with other valve pathologies were excluded. The mean aortic valve area was 0.7+/- 0.09 cm2. The following fourteen variables were analyzed: etiology, age (= or >70 years), sex, preoperative New York Heart Association (NYHA) functional class, @entity1030 , @entity101 , @entity6 , @entity3657 , @entity740 , need for concomitant procedures for the ascending aorta, cardiopulmonary bypass time = or >120 min, aortic cross-clamp time = or >90 min, intraaortic balloon pump support and inotropic support. Statistical analysis for comparison of pre- and postoperative changes in clinical and functional variables was performed using Wilcoxon rank test. The predictors of early mortality after AVR were analyzed using logistic regression analysis and late survival was studied using Cox proportional regression and Kaplan Meier survival analyses. RESULTS: Operative mortality was 8.6% with four @entity1 . As the result of univariate logistic regression analysis, preoperative NYHA functional class = or >3 was found to be predictive of early mortality. @entity1 with NYHA class = or >3 had 12.6 times (OR: 12.6; 95%CI: 1.2-131.3; p=0.035) higher probability of early mortality than those with a lower NYHA class. However, multivariate logistic regression analysis demonstrated no predictor for early mortality. A positive change was observed in the LVEF in 79.3% of survivors and the mean LVEF increased from 34.5+/- 3.9% to 44.7+/- 10.4% (p<0.001). There were eight (19%) late deaths. Actuarial survival was 83. +/- 5.9% at 5 years and 59.6% +/- 10.9% at 10 years. Cox proportional hazards regression analysis demonstrated @entity6 (HR: 6.6; 95% CI: 1.19-36.9, p=0.031) and intraaortic balloon pump use (HR: 10.7; 95% CI: 2.9-39.7, p<0.001) as significant predictors for late mortality. CONCLUSION: Left ventricular ejection fraction and symptoms improve after AVR in @entity1 with isolated severe @entity472 and @entity1002 with an acceptable operative mortality and satisfactory long-term survival.

Aortic valve replacement in isolated severe XXXX with @entity1002 : long-term survival and ventricular recovery.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes', 'diabetes mellitus'] @entity3657 :: ('MESH:D058729', 'Disease') :: ['peripheral arterial disease'] @entity740 :: ('MESH:D051436', 'Disease') :: ['chronic renal insufficiency'] @entity337 :: ('MESH:D001022', 'Disease') :: ['aortic regurgitation'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic obstructive pulmonary disease'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'aortic stenosis'] @entity1002 :: ('MESH:D018487', 'Disease') :: ['LVD', 'left ventricular dysfunction']
@entity472 :: (MESH:D001024,Disease) :: ['aortic stenosis']
