Late incidence and predictors of persistent or recurrent heart failure in patients with aortic prosthetic valves

Ruel, Marc; Rubens, Fraser D.; Masters, Roy G.; Pipe, Andrew; Bédard, Pierre; Hendry, Paul; Lam, Buu Khanh; Burwash, Ian G.; Goldstein, William; Brais, Maurice; Keon, Wilbert J.; Mesana, Thierry G.

doi:10.1016/j.jtcvs.2003.07.043

Cited by 128 publications

(130 citation statements)

References 26 publications

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“…3,13 Indexed EOA was calculated by using the patients' body surface area at the time of operation. Prosthesis-patient mismatch (PPM) was defined as an indexed EOA ≤0.85 cm 2 /m 2 .…”

Section: Methodsmentioning

confidence: 99%

“…1,2 The outcomes of AVR have improved over the last decade, 1 but the incidence and mortality of congestive heart failure (CHF) after AVR remain high among patients with left ventricular (LV) dysfunction. [3][4][5] One possible mechanism is nonrecovery of LV dysfunction after AVR. Because LV function affects clinical outcomes, 3,6 incomplete LV recovery postoperatively may translate into decreased survival and quality of life.…”

mentioning

confidence: 99%

“…[3][4][5] One possible mechanism is nonrecovery of LV dysfunction after AVR. Because LV function affects clinical outcomes, 3,6 incomplete LV recovery postoperatively may translate into decreased survival and quality of life. Usually, LV function worsens with long-standing pressure or volume overload and recovers after AVR with relief of this overload.…”

mentioning

confidence: 99%

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Clinical Impact of Changes in Left Ventricular Function After Aortic Valve Replacement

et al. 2015

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Background-Our objectives were to identify correlates of mortality and congestive heart failure after aortic valve replacement (AVR) according to preoperative left ventricular (LV) function and to describe the incidence, time course, and correlates of LV recovery and mass regression postoperatively. Methods and Results-A total of 3112 patients with AVR were assessed in a follow-up clinic with echocardiography (median follow-up, 6.0 years). At operation, their mean age was 67.8±13.4 years, one third were female, and 29% had LV dysfunction (ejection fraction <50%). In severe patients with severe aortic stenosis and LV dysfunction, transaortic valve mean pressure gradient <40 mm Hg, longer cardiopulmonary bypass duration, and prosthesis-patient mismatch (indexed effective orifice area ≤0.85 cm 2 /m 2 ) were independent correlates of the composite outcome of death or congestive heart failure after AVR. In patients with severe aortic regurgitation and LV dysfunction, older age and higher preoperative LV mass were identified. LV recovery correlated with better survival and freedom from heart failure in patients with aortic stenosis. Maximum LV mass regression took 24 months in patients with aortic stenosis and nearly 5 years with aortic regurgitation; independent correlates included smaller LV end-systolic diameter in patients with aortic stenosis and low New York Heart Association class with aortic regurgitation. Conclusions-Incomplete LV recovery, prosthesis-patient mismatch, low transaortic valve pressure gradient, and higher LV mass are associated with increased mortality or heart failure after AVR in patients with LV dysfunction. Higher LV end-systolic diameter and symptoms correlate with less LV mass regression, which takes at least 2 years. These findings help surgeons and cardiologists refine the indications, timing, prognostication, and follow-up of patients before and after AVR. (Circulation. 2015;132:741-747.

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“…3,13 Indexed EOA was calculated by using the patients' body surface area at the time of operation. Prosthesis-patient mismatch (PPM) was defined as an indexed EOA ≤0.85 cm 2 /m 2 .…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical Impact of Changes in Left Ventricular Function After Aortic Valve Replacement

et al. 2015

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“…However, the authors pointed out that PPM might have been found to have a significant effect in the normal LV function cohort had they evaluated cases with severe mismatch (≤ 0.65 cm 2 / m 2 ). An earlier study by Ruel et al (2004) had shown that although PPM had significant effects on cardiac end points (occurrence of congestive heart failure, etc), it had no effect on overall survival after AVR. Kulik et al (2006) found that patients with low-gradient aortic stenosis (LGAS, defined as an aortic valve area of < 1.2cm 2 , a mean transvalvular pressure gradient of < 40 mmHg, and a LVEF of < 50%) have worse long-term outcomes after AVR, and that PPM further adversely affects the long-term outcomes of LGAS patients and should therefore be avoided in this population.…”

Section: Carpentier-edwardsmentioning

confidence: 98%

Influence of Prosthesis-Patient Mismatch on Survival with Aortic Valve Replacement

Jamieson¹,

Zhang²,

Higgins³

et al. 2011

Aortic Valve

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“…This discordance is due in fact to different ways of evaluating EOA. As a whole, studies based on an in vivo evaluation of the indexed EOA tend to report clinical implications (Blais et al, 2003, Ruel et al, 2004, Tasca et al, 2006. In the contrary, the in vitro evaluation of the indexed EOA tends to underestimate clinical implications of PPM (Koch et al, 2005).…”

mentioning

confidence: 99%

Patient-Prosthesis Mismatch After Aortic Valve Replacement

Wauthy¹,

Malekzadeh‐Milani²

2011

Aortic Valve Stenosis - Current View on Diagnostics and Treatment

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Late incidence and predictors of persistent or recurrent heart failure in patients with aortic prosthetic valves

Cited by 128 publications

References 26 publications

Clinical Impact of Changes in Left Ventricular Function After Aortic Valve Replacement

Clinical Impact of Changes in Left Ventricular Function After Aortic Valve Replacement

Influence of Prosthesis-Patient Mismatch on Survival with Aortic Valve Replacement

Patient-Prosthesis Mismatch After Aortic Valve Replacement

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