title: Long-term results of surgical treatment of aortic and mitral regurgitation with enlarged left ventricle.
abstract: Mitral valve and aortic valve regurgitation associated with enlarged left ventricle remains difficult to manage and the long-term results following surgical treatment is uncertain. Between April 1988 and September 2000, 82 patients with aortic and mitral regurgitation associated with enlarged left ventricle underwent valve replacement at Anzhen Hospital. The valve disease was rheumatic in origin in 75 patients (91.5%) and congenital in 7 (8.5%). Twenty-eight patients were in New York heart Association Functional (NYHA) class II and 39 in class III and 15 in class IV. Echocardiogram showed severe aortic insufficiency associated with mild to moderate mitral regurgitation in 66 patients and severe mitral regurgitation associated with mild to moderate AI in 16 patients. The mean left ventricular diastole diameter (LVDD) was 77.8 ± 5.2 mm. Valve replacement was performed under hypothermic cardiopulmonary bypass (CPB). Early hospital mortality was 7.3%. Two weeks after surgery the echocardiogram showed a reduction of LVDD. Follow up was completed in 69 patients with mean of 13.5 years. 20 patients were in NYHA class I; 26 in Class II and 3 in Class III and 2 in class IV. The follow-up survival rate was 73.9%, and follow-up mortality was 26.1%. LVDD reduced from 77.8 ± 5.2 mm to 58.3 ± 4.5 mm (P < 0.001). In 24 patients, the LVDD was less than 50 mm. Double valve replacement and/or repair carried out an acceptable early and Long-term clinical outcomes in patients with MR and AI with associated LV great enlargement. Both LVDD and NYHA improved following surgical treatment in survival patients.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Anyang Hospital of Traditional Chinese Medicine Anyang, Henan Province 455000, China.
authors.forename: Xian-Min
authors.initials: XM
authors.lastname: Liu
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China ; Department of Cardiac Surgery, Hangzhou Second Hospital, Hangzhou Normal University Zhejiang Province 310005, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of ICU, Jiaozuo People's Hospital Henan Province 454750, China.
authors.forename: Wu-Kui
authors.initials: WK
authors.lastname: Zhang
authors.affiliation: Department of Cardiac Surgery, Hangzhou Second Hospital, Hangzhou Normal University Zhejiang Province 310005, China.
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Xu
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Xiu-Fang
authors.initials: XF
authors.lastname: Xu
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Wen-Bin
authors.initials: WB
authors.lastname: Li
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Meng
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Bao-Tian
authors.initials: BT
authors.lastname: Chen
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Qi-Wen
authors.initials: QW
authors.lastname: Zhou
authors.affiliation: Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing 100029, China.
authors.forename: Zi-Fan
authors.initials: ZF
authors.lastname: Zhou
keywords: Surgical treatment; aortic insufficiency; enlarged left ventricular; mitral regurgitation
references.citation: Ann Thorac Surg. 2014 Mar;97(3):816-23
references.pmid: 24280184
references.citation: Ann Thorac Surg. 2005 Jun;79(6):1939-44
references.pmid: 15919288
references.citation: Curr Probl Cardiol. 1998 Apr;23(4):202-41
references.pmid: 9589842
references.citation: Heart Lung Circ. 2001;10(2):A11-6
references.pmid: 16352025
references.citation: J Heart Valve Dis. 2010 Jul;19(4):473-84
references.pmid: 20845896
references.citation: Am J Cardiol. 1983 Mar 15;51(6):1005-28
references.pmid: 6338691
references.citation: Circulation. 1993 Apr;87(4):1378-88
references.pmid: 8462159
references.citation: Zhonghua Wai Ke Za Zhi. 2003 Apr;41(4):243-6
references.pmid: 12882662
references.citation: Jpn Heart J. 1992 Sep;33(5):605-18
references.pmid: 1289593
references.citation: J Heart Valve Dis. 2002 Mar;11(2):181-4
references.pmid: 12000157