Survival Benefit of Aortic Valve Replacement in Older Patients With Asymptomatic Chronic Severe Aortic Regurgitation

Turk, Rami; Varadarajan, Padmini; Kamath, Ashvin; Sampat, Unnati; Khandhar, Sumit; Patel, Reena; Pai, Ramdas G.

doi:10.1016/j.athoracsur.2009.12.008

Cited by 19 publications

(11 citation statements)

References 18 publications

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“…After AVR, LVEDD are usually reduced within a few days after operation, resulting in reduction in preload and a transient decrease of LVEF 14,17. In our study, we found significant reduction in LVEDD in patients in whom remodeling occurred, and no reduction in LVEDD in patients without remodeling.…”

Section: Discussionsupporting

confidence: 50%

“…Recent ACC/AHA guidelines for AVR do not recommend surgery in patients of AR with EF <50%, LVEDD >70 mm, and LVESD >50 mm 13. Turk et al operated patients with these parameters and concluded that AV replacement in these patients is associated with significant survival rate 14. According to Euro heart survey only 32% patients with LVEF <50% to 30% undergo AVR and only 3% with LVEF<30% 15.…”

Section: Discussionmentioning

confidence: 99%

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Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

Rizvi¹,

Khalid²,

Baksh³

et al. 2016

Pak J Med Sci

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Objectives:To evaluate the frequency of early remodeling in patients of severe aortic regurgitation after aortic valve replacement and to see the incidence of early remodeling in patients with stroke volume >97 ml versus < 97 ml before aortic valve replacement.Method:This was a prospective comparative study conducted from August 2013 to December 2014 in a tertiary care hospital. Fifty seven (57) patients of isolated chronic aortic regurgitation were included in this study. SPSS v23 was used for data analysis. Independent sample t-test was used for analysis of continuous variables and chi-square test for qualitative variables.Results:Out of fifty seven patients, early remodeling occurred in 34 (59.64%) patients after surgery. The mean pre-operative stroke volume of patient in whom remodeling occurred was 110.3+9.66 ml while mean pre-operative stroke volume of patients who did not undergo remodeling was 86.65+7.63 ml. There were 28 (82.4%) patients with stroke volume >97 ml in whom Remodeling occurred where as in patients with stroke volume <97 ml remodeling occurred only in 6 (17.6%) patients (p value 0.004). There was no in-hospital mortality.Conclusion:There is an association between stroke volume and early LV remodeling after Aortic valve replacement. Stroke volume >97 ml is a good predictor of early LV remodeling.

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Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

Rizvi¹,

Khalid²,

Baksh³

et al. 2016

Pak J Med Sci

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“…Therefore, LVEF decreases temporarily. [22][23][24] In our study, both groups had great reduction in iEDD and iESD, but the decrease in iESD in Group S was smaller than in Group L. That's why the grade of LVEF decline was greater in Group L but Group S had significantly better LVEF than Group L. After discharge, Group L had additional improvement in LV dimensions, and LV function reached a plateau at the early period after the operation. This chronological change could result from the reduced afterload with gradual improvement in LV function after surgery or it might show an actual improvement in contractile function and would indicate that it takes about one year to make sure of the improvement of LV function with AVR.…”

Section: Discussionmentioning

confidence: 55%

“…Turk et al investigated whether AVR would yield a survival benefit in asymptomatic severe AR patients with those parameter values and showed that AVR was associated with significant survival benefit. 22) Considering the declining operative mortality of AVR and the improvement of perioperative management, these results possibly support a strategy of earlier surgery for AR and despite serving as a class III indication, AVR could be indicated in severe asymptomatic AR patients with normal LVEF and lesser LV dilatation.…”

Section: Discussionmentioning

confidence: 95%

Long Term Results and Predictors of Left Ventricular Function Recovery after Aortic Valve Replacement for Chronic Aortic Regurgitation

Saisho

Arinaga

Kikusaki

et al. 2015

ATCS

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“…In the following, Ross replaced the aortic valve with homobiological valve in 1962 [2]. Valve replacement is the efficient method to treat valve dysfunction of heart valve diseases [3][4][5]. However, those patients who have had valve replacement operations with mechanical valves should take anti-coagulation medicine for the residual life and serious complications of thrombus and over anti-coagulation bleeding were used to happen [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Tissue-type plasminogen activator gene targets thrombolysis in atriums

Gong

Wang

et al. 2010

J Thromb Thrombolysis

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Our previous investigations showed that retroviral gene transfer of tissue-type plasminogen activator (tPA) effectively targeted thrombolysis in vitro and in the model of inferior caval veins of rabbits. This study is to identify the target thrombolysis of retroviral vector recombinant pLEGFP-N1-tPA transferred into the tissue around the Dacron patch (the same materials making of the ring of mechanical valve) in left atriums of rabbits. 70 Dacron patches were transplanted into the left atriums of 70 New Zealand white rabbits. The rabbits were randomly divided into three groups according to the different handling methods, including local pLEGFP-N1-tPA transferred group (gene therapy group, 30 animals), pLEGFP-N1 transferred group (control group, 20 animals), medium DMEM + 10% neonate calf serum (NCS) injected group (blank control group, 20 animals). Samples of blood, Dacron pieces and left atriums (auricles) wall from half of above in each group were harvested on second day and another half were harvested on 75th day after surgery. The EGFP expression of harvested left atriums (auricles) wall were observed under the confocal. The thrombi on the surface of Dacron patches were detected by stereoscope and electron microscope. The tPA expression in left atriums (auricles) wall and in blood from left atriums were detected by Western blot and their thrombolysis and activities were observed and calculated in plasma plates. ELISA were used to identify the contents of tPA. No thrombus was seen on the surface of Dacron patches that were transplanted in left atriums by tPA locally transferring around them. Activity and content of tPA were high in local tissue of left atrium and in blood of left atrium. It demonstrated effectively thrombolysis by tPA rapidly, efficiently and long expressing. This puts the foundation of mechanical valve replacement model for tPA gene valve, next.

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Survival Benefit of Aortic Valve Replacement in Older Patients With Asymptomatic Chronic Severe Aortic Regurgitation

Cited by 19 publications

References 18 publications

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

Frequency of early remodeling of left ventricle and its comparison between patients with stroke volume >97 Ml versus patients with stroke volume <97 Ml after aortic valve replacement for severe aortic regurgitation

Long Term Results and Predictors of Left Ventricular Function Recovery after Aortic Valve Replacement for Chronic Aortic Regurgitation

Tissue-type plasminogen activator gene targets thrombolysis in atriums

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