[Risk factors influencing the prognosis of severe aortic valve disease following aortic valve replacement].
As a result of improvement in intraoperative and postoperative management, severe aortic valve disease can be cured by operation, however, late cardiogenic sudden death after aortic valve replacement (AVR) has been existed as one of the important unsolved problem. This report is aimed to predict the risk factors influencing the postoperative prognosis of severe aortic valve disease. Twenty-three cases with aortic regurgitation (AR) and 20 cases with aortic stenosis (AS) were selected by postoperative period over 12 months. In 18 AR cases with normal coronary artery substantiated by selective coronary angiography, cross sectional area index of left ventricular wall (CSAI) and ST depression in left chest leads of electrocardiogram correlated well as the CSAI increased, so decreased the ST segment. This shows the increment of CSAI leads left ventricular endocardial ischemia. By means of introduction of this indicator, 23 AR and 20 AS patients were divided into two groups as group C-I having CSAI over 20 cm2/m2 and group C-II under 20 cm2/m2. Left ventricular ejection fraction (EF) was selected as an predictive indicator of left ventricular function. As same as CSAI, AVR cases were divided into two groups as group E-I having EF under 50% and E-II over 50%. Each group was compared concerning with the complication rate of postoperative low cardiac output syndrome (LOS) and late cardiogenic sudden death. In C-I group of AR, 55% cases accompanied with LOS, 18% died due to LOS and 18% died suddenly from late cardiogenic cause, however, none of cases in C-II group had these complications.(ABSTRACT TRUNCATED AT 250 WORDS)
Okamura
K
K
Department of Cardiovascular Surgery, University of Tsukuba, Ibaraki, Japan.
Watanabe
Y
Y
Koishizawa
T
T
Maeta
H
H
Mitsui
T
T
Hori
M
M
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D002303:Cardiac Output, Low / Q000453:epidemiology; D003645:Death, Sudden / Q000453:epidemiology; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors