Mass Reduction and Functional Improvement of the Left Ventricle after Aortic Valve Replacement for Degenerative Aortic Stenosis

대한흉부외과학회지 2011년 44권 6호 p.399 ~ p.405

신수민(Shin Su-Min) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
박표원(Park Pyo-Won) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
한우식(Han Woo-Sik) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
성기익(Sung Ki-Ick) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
김욱성(Kim Wook-Sung) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery
이영탁(Lee Young-Tak) - Sungkyunkwan University School of Medicine Department of Thoracic and Cardiovascular Surgery

Abstract

Background:Left ventricular (LV) hypertrophy caused by aortic valve stenosis (AS) leads to cardiovascular morbidity and mortality. We sought to determine whether aortic valve replacement (AVR) decreases LV mass and improves LV function.

Materials and Methods : Retrospective review for 358 consecutive patients, who underwent aortic valve replacement for degenerative AS between January 1995 and December 2008, was performed. There were 230 men and 128 women, and their age at operation was 63.2±10 years (30∼85 years).

Results:There was no in-hospital mortality, and mean follow-up duration after discharge was 48.9 months (2∼167 months). Immediate postoperative echocardiography revealed that LV mass index and mean gradient across the aortic valve decreased significantly (p<0.001), and LV mass continued to decrease during the follow-up period (p<0.001). LV ejection fraction (EF) temporarily decreased postoperatively (p<0.001), but LV function recovered immediately and continued to improve with a significant difference between preoperative and postoperative EF (p<0.001). There were 15 late deaths during the follow-up period, and overall survival at 5 and 10 years were 94% and 90%, respectively. On multivariable analysis, age at operation (p=0.008), concomitant coronary bypass surgery (p<0.003), lower preoperative LVEF (<40%) (p=0.0018), and higher EUROScore (>7) (p=0.045) were risk factors for late death.

Conclusion:After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.

키워드

Aortic valve replacement, Aortic stenosis, Left ventricular hypertrophy
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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
After AVR for degenerative AS, reduction of left ventricular mass and improvement of left ventricular function continue late after operation.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
KCD코드
ICD 03
건강보험코드