Prognosis and long-term results of surgically treated aortic stenosis.
A total of 675 patients (mean age 60 +/- 11 years, range 22-85, 71% males) with calcified pure aortic stenosis (490) or mixed lesions (185) had an aortic prosthesis: 290 Starr-Edwards, 147 Bjork, 18 other mechanical valves, 163 pericardial xenografts, 57 porcine xenografts; 76 patients simultaneously underwent a coronary bypass, 12 a replacement of ascending aorta, and six a mitral valvuloplasty. Preoperatively, 67% were in functional class III or IV (NYHA); 69.5% had a coronary arteriography: significant coronary stenosis was observed in 27% of patients. The operative mortality was 6.8% depending on the functional class at surgery, age (4.9% before 70 years, vs. 12.5% after), and the date of surgery (8.1% before 1983 vs. 3.7% after). The 10- and 15-year actuarial survival rates were 62 +/- 3% and 44 +/- 4%, respectively. No significant differences were observed between patients with pure aortic stenosis and mixed aortic lesions. In patients over 70 years, the survival rates were 71 +/- 5% at five years and 51 +/- 10% at 10 years. Age, functional class, degree of congestive heart failure, and degree of cardiomegaly were the main preoperative predictors of late death. At 10 years, 88% of patients were free from myocardial dysfunction, 87% from thromboembolic events, and 89% from haemorrhages. We conclude that in this type of valvulopathy, short- and long-term surgical results are good despite the fact that most patients are elderly and in an advanced functional class.
Cormier
B
B
Department of Cardiology, Hôpital Tenon, Paris, France.
Luxereau
P
P
Bloch
C
C
Ducimetiere
P
P
Boustani
F
F
Badaoui
G
G
Dybantsa
P
P
Cheung
P
P
Preud'homme
G
G
Acar
J
J
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000209:etiology / Q000601:surgery*; D002114:Calcinosis / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011379:Prognosis
D011093:Polyethylene Terephthalates