Late survival after valve operation in patients with left ventricular dysfunction.

Published

Journal Article

BACKGROUND: Left ventricular dysfunction is a predictor of hospital mortality after cardiac valve operation. We evaluated late survival in a large cohort of these patients. METHODS: 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. RESULTS: 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 p < 0.05). 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 p < 0.05). CONCLUSIONS: 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.

Full Text

Duke Authors

Cited Authors

  • Duarte, IG; Murphy, CO; Kosinski, AS; Jones, EL; Craver, JM; Gott, JP; Guyton, RA

Published Date

  • October 1997

Published In

Volume / Issue

  • 64 / 4

Start / End Page

  • 1089 - 1095

PubMed ID

  • 9354533

Pubmed Central ID

  • 9354533

International Standard Serial Number (ISSN)

  • 0003-4975

Language

  • eng

Conference Location

  • Netherlands