90 92

Cited 0 times in

심한 대동맥 판막협착증으로 대동맥 판막 대치술을 시행 받은 환자에서 장기 생존에 영향을 미치는 인자

Other Titles
 Long-term Prognostic Factors after Aortic Valve Replacement of Severe Aortic Stenosis 
 이주용  ;  하종원  ;  장병철  ;  강석민  ;  임세중  ;  정남식  ;  심원흠  ;  조승연  ;  김성순 
 Korean Circulation Journal (순환기), Vol.31(9) : 877-883, 2001 
Journal Title
 Korean Circulation Journal  (순환기) 
Issue Date
Background : The long term prognostic factors of aortic valve replacement (AVR) in patients with severe aortic stenosis (AS) with normal and low left ventricular function are not well known in the Korean population. Methods : Between 1990 and 1999 , 73 patients (52 male, 21 female, mean age : 58±10.7) with severe AS underwent AVR in Yonsei Cardiovascular Hospital. Patients were excluded if they had concomitant valvular operations other than AVR, previous AVR, or more than a moderate amount aortic valve regurgitation, or were under 18 years old. Overall survival was estimated by the Kaplan-Meier method, and the Cox proportional hazards model was used to analyze the predictors that influence long-term survival. Results : The causes of aortic stenosis were degenerative (44 case, 60%), congenital (26 case, 36%), and rheumatic (3 case, 4%) in nature. The preoperative characteristics (mean±SD) included ejection fraction (EF), 58±16.5%; mean aortic pressure gradient, 63±20 mmHg ; aortic valve area, 0.62±0.13㎠. Simultaneous coronary artery bypass surgery and percutaneous transluminal coronary angioplasty were performed in 8 and 2 cases, respectively. The comparative results in all total patients of the pre/post operative echocardiography showed a significant improvement ; EF of 58±17/64±12%, aortic valve area(AVA) of 0.64±0.15/1.54±0.63 ㎠, mean pressure gradient (MPG) of 63±21/23±13 mmHg, left ventricular end-diastolic dimension (LEEDD) of 54±9/50±9 mmHg, and a left ventricular posterior wall thickness in systole (LV-PW) of 18±2/16±2 mm. The comparative results of the pre/post operative echocardiography of low EF patients (<35%) also showed a significant improvement; EF of 30±4/55±15%, AVA of 0.59±0.14/1.67±0.85 ㎠, MPG of 52±20/21±12 mmHg, LVEDD of 58±8/51±6 mm. Operative (30-day) mortality was 2.7% (2 of 73 patients). Six additional patients died during follow-up. The survival of patient group was 86% at 5 years and 78% at 10 years. The predictors of long-term postoperative survival were preop-EF (p<0.05, R=0.26) and the presence of significant coronary artery disease (CAD) (p<0.01, R=0.35). Conclusion : Postoperative long-term survival of severe AS after AVR was negatively related to reduced preop-EF and the presence of significant CAD. Therefore, the early operative treatment before the occurrence of irreversible left ventricular dysfunction and concomitant appropriate management of coronary artery disease is necessary for the improvement of the survival after AVR.
Files in This Item:
T200103140.pdf Download
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
임세중(Rim, Se Joong)
하종원(Ha, Jong Won) ORCID logo https://orcid.org/0000-0002-8260-2958
RIS (EndNote)
XLS (Excel)
사서에게 알리기


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.