title: Severe aortic regurgitation and reduced left ventricular ejection fraction: outcomes after isolated aortic valve replacement and combined surgery.
abstract: BACKGROUND
  In patients with severe aortic regurgitation and reduced left ventricular ejection fraction (LVEF), uncertainty remains whether to recommend aortic valve replacement (AVR) over heart transplantation, especially when mitral regurgitation and/or coronary heart disease coexist.
  
  
  METHODS
  We assessed outcomes in 26 consecutive AVR patients aged </=70 years with severe aortic regurgitation and reduced LVEF, comparing the group undergoing isolated AVR with the group requiring combined surgery.
  
  
  RESULTS
  The difference in mortality and morbidity between the groups was 10% vs 6%, which was not significant (p = 0.6 in both cases). Also observed was a significant improvement in functional class and a reduction in LV end-diastolic diameter from a median value of 69 to 64 mm in the isolated AVR group and to 66 mm in the combined group (p < 0.05).
  
  
  CONCLUSIONS
  AVR in patients with symptomatic severe aortic regurgitation and reduced LVEF is feasible, even in the presence of concomitant mitral regurgitation and/or coronary heart disease requiring a combined surgical procedure.
authors.affiliation: Cardiology Department, Thorax Institute, Hospital Clinic, Institut d'Investigaciones Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sionis
authors.forename: Ana
authors.initials: A
authors.lastname: García-Alvarez
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Castel
authors.forename: Marco
authors.initials: M
authors.lastname: Cordero
authors.forename: Miguel
authors.initials: M
authors.lastname: Josa
authors.forename: Félix
authors.initials: F
authors.lastname: Pérez-Villa
authors.forename: Eulàlia
authors.initials: E
authors.lastname: Roig
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000503:physiopathology; D016027:Heart Transplantation; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000601:surgery*