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류마티스성 승모판막 수술 시 동반된 경도 또는 중등도 대동맥판막 질환의 장기 추적관찰

Other Titles
 Long-Term Outcome of Clinically Insignificant Aortic Valve Disease in Patients Undergoing Mitral Valve Surgery for Rheumatic Heart Disease 
Authors
 최승혁  ;  하종원  ;  장병철  ;  남정모  ;  장양수  ;  정남식  ;  심원흠  ;  조승연  ;  김성순 
Citation
 KOREAN CIRCULATION JOURNAL, Vol.31(10) : 1034-1041, 2001 
Journal Title
KOREAN CIRCULATION JOURNAL(순환기)
ISSN
 1738-5520 
Issue Date
2001
Keywords
Aortic valve;Disease progression;Survival
Abstract
Background and Objectives : A considerable proportion of patients who require mitral valve (MV) replacement present with a coexisting pathology of the aortic valve (AV). However, combined AV and MV replacement is associated with increased operative risk and lower long-term survival rates than MV replacement (MVR) alone. Little is known concerning the natural history of AV disease in patients undergoing MV surgery. The purpose of this study was to analyze the long-term clinical outcome and requirements for subsequent AV replacement (AVR) in patients with mild to moderate AV disease at the time of MV surgery. Materials and Method: One hundred forty-one patients (97 female, mean age 43 years) with mild to moderate AV disease and severe rheumatic MV disease were treated with MV surgery. The patients were followed for an average period of 8±3 years (range 1-16) following MV surgery. Primary outcomes (death and subsequent AVR) were evaluated. Results: At the time of MV surgery, 104 patients (73.8%) had mild aortic regurgitation (AR), 37 patients (26.2%) moderate AR, 5 patients (3.5%) mild aortic stenosis (AS) and 2 patients (1.4%) moderate AS. At the end of the follow-up period only one patient had severe AR. Eight patients (5.7%) died during the follow-up, and four patients (2.8%) were treated with AVR after a mean period of 9 years. A survival analysis with using the Kaplan-Meier method revealed a 10-year survival rate of 95.5% and a 10-year event free survival rate of 93.6%. Conclusion: In most patients with mild to moderate rheumatic AV disease at the time of MV surgery, subsequent AVR is rarely required after a long follow-up period. This data may support a decision not to recommend prophylactic AVR at the time of MV surgery in these patients.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Nam, Chung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Chang, Byung Chul(장병철)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142062
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