[Results of surgical treatment of calcified aortic valve stenosis: report of a series of 4,129 interventions]. / Résultats du traitement chirurgical du rétrécissement valvulaire aortique calcifié: à propos d'une série de 4,129 interventions.
Bull Acad Natl Med
; 185(1): 163-74; discussion 174-5, 2001.
Article
en Fr
| MEDLINE
| ID: mdl-11474565
Aortic stenosis (AS) is the most common lesion currently encountered among valvular heart disease, particularly in elderly people. Severe functional impairment and risk of sudden death explain that surgical treatment is largely accepted. We report a retrospective analysis of institutional experience with aortic valve replacement (AVR) for AS from 1971-1997 in 4,129 patients. Age ranged from 13 to 91 years (mean 68 +/- 10) and degenerative disease was largely predominant (86%). For AVR, mechanical prostheses were used in 2,054 patients (50.2%) and bioprostheses in 2,075 (48.8%) in elderly group. Coronary artery revascularization was associated in 670 patients (16%). Operative mortality was 7% (303 pts) and main cause was left ventricular failure (52%). Late results were studied with a maximum follow-up of 26 years. Total follow-up represents 21,533 pt-years. Late death occurred in 1,108 patients between 1 month and 24 years after operation (mean 6.6 years). Reoperation was necessary in 136 cases. Actuarial survival--including operative mortality--was 77% and 56% at 5 and 10 years. A large functional improvement was observed in the vast majority of patients, 73% being I or II subgroups of the NYHA classification. Incremental risk factors for death (immediate as well as late) were older age, preoperative functional status, emergency, presence of cardiac failure, coronary artery lesions and associated morbidity. The choice of valvular prosthesis remains controversial, but the results show that AVR is the procedure of choice for the vast majority of patients wtih significant aortic valve disease.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Estenosis de la Válvula Aórtica
/
Calcinosis
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Fr
Revista:
Bull Acad Natl Med
Año:
2001
Tipo del documento:
Article
Pais de publicación:
Países Bajos