title: [Results of aortic stenosis surgery in patients with severe ventricular dysfunction].
abstract: OBJECTIVE
  To study the short and long term clinical course of patients with severe aortic stenosis after surgical treatment of the valvular lesion.
  
  
  METHODS
  Thirty survivors among 31 consecutive patients with severe left ventricular dysfunction (LVD) due to aortic stenosis (AS) were submitted to clinical and echocardiographic follow-up during a mean of 30 months after surgical treatment of the valvular lesion. Twenty five (83.3%) patients were male with a mean age of 50 years (25 to 74). Before operation the following parameters were obtained: diastolic left ventricular diameter (DLVD), shortening fraction (SF), left ventricular ejection fraction (LVEF), aortic valve area (AVA), left ventricular-aortic pressure gradient (PG) and NYHA functional class (FC). During the follow up, after the surgical procedure, FC, DLVD, LVEF and SF could be analysed and compared with previous data.
  
  
  RESULTS
  A significant rise in SF (p = 0.001) and LVEF (p = 0.0001), as well as a decrease in DLVD (p = 0.001) were observed in the follow up. Symptoms lessened in severity in the majority of patients. Three of our patients died with progressive LVD and heart failure, after at least 36 months of follow-up. These results indicate that when operation is carried out in patients with AS and left ventricular failure, a significant improvement in left ventricular function and in symptoms takes place. Although the risk of surgical treatment is increased in this group of patients, LVD should not be considered a contraindication to the procedure.
  
  
  CONCLUSIONS
  The left ventricular dysfunction is not a contraindiction for the surgical treatment of the aortic stenosis.
authors.affiliation: Instituto do Coração do Hospital das Clínicas-FMUSP.
authors.forename: P M
authors.initials: PM
authors.lastname: Pomerantzeff
authors.forename: F
authors.initials: F
authors.lastname: Tarasoutchi
authors.forename: F S
authors.initials: FS
authors.lastname: de Brito Júnior
authors.forename: A M
authors.initials: AM
authors.lastname: Munhoz
authors.forename: L F
authors.initials: LF
authors.lastname: Cardoso
authors.forename: C M
authors.initials: CM
authors.lastname: Brandão
authors.forename: M
authors.initials: M
authors.lastname: Grinberg
authors.forename: N A
authors.initials: NA
authors.lastname: Stolf
authors.forename: G
authors.initials: G
authors.lastname: Bellotti
authors.forename: F
authors.initials: F
authors.lastname: Pileggi
authors.forename: A D
authors.initials: AD
authors.lastname: Jatene
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D015150:Echocardiography, Doppler; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left
vernacular_title: Resultados da cirurgia da estenose aórtica em pacientes com disfunção ventricular grave.