Are patients with isolated chronic aortic regurgitation operated in time? Analysis of survival data over a decade.
BACKGROUND
Patients suffering from chronic isolated aortic regurgitation have a less favorable outcome than patients with aortic stenosis. According to international recommendations, these patients should undergo surgery as soon as left ventricular function begins to deteriorate, that is, surgery is not to be postponed until clinical symptoms become relevant.


OBJECTIVE
The study was undertaken to evaluate how satisfactory our timing of surgery was, as reflected by survival data.


METHODS
Survival was studied retrospectively in a consecutive series of patients undergoing surgery for chronic isolated aortic regurgitation during a 10-year period in our institution. Results were compared with data from the literature. By excluding patients with aortic aneurysms and acute endocarditis, we formed a homogeneous patient group of 88 subjects.


RESULTS
Thirty-day mortality was 1% and late mortality after a mean follow-up period of 6 years was 11%. Compared with survival data from an earlier study in which the patient population was similar and resided in the same geographic area, the results in our patient group seem to be better. It is noteworthy that despite a strong effort to recommend surgery at an earlier stage of the disease than previously, 35% of the patients had moderate or severe left ventricular dysfunction preoperatively because of late referrals.


CONCLUSIONS
This stresses the importance of early detection and careful preoperative follow-up with noninvasive methods in patients with aortic regurgitation.
Tamás
Eva
E
Department of Cardiothoracic Surgery, Linköping Heart Center, University Hospital, Linköping, Sweden. evtam@imv.liu.se
Nylander
Eva
E
Olin
Christian
C
D000328:Adult; D000368:Aged; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000401:mortality* / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000601:surgery