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Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?

Authors
 Jong-Won Ha  ;  Seung-Hyuck Choi  ;  Byung-Chul Chang  ;  Chung Mo Nam  ;  Yangsoo Jang  ;  Namsik Chung  ;  Won-Heum Shim  ;  Seung-Yun Cho  ;  Sung-Soon Kim 
Citation
 Annals of Thoracic Surgery, Vol.74(4) : 1115-1119, 2002 
Journal Title
 Annals of Thoracic Surgery 
ISSN
 0003-4975 
Issue Date
2002
MeSH
Adult ; Aortic Valve/surgery* ; Aortic Valve Insufficiency/complications ; Aortic Valve Stenosis/complications ; Disease Progression ; Echocardiography ; Female ; Follow-Up Studies ; Heart Valve Diseases/mortality ; Heart Valve Diseases/surgery* ; Humans ; Male ; Mitral Valve/surgery* ; Rheumatic Heart Disease/surgery ; Survival Rate ; Treatment Outcome
Abstract
BACKGROUND: Determining the need for surgical treatment of coexisting mild to moderate aortic valve disease in patients referred for mitral valve surgery is often difficult. The purpose of this study was to assess long-term clinical outcome and the need for subsequent aortic valve replacement in patients with mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery. METHODS: A total of 275 patients (90 men and 185 women, mean age 43 years) with rheumatic disease who underwent mitral valve surgery were followed up for an average of 9 years. Patients were classified into two groups: those with coexisting mild to moderate aortic valve disease at the time of mitral valve surgery (141 patients, group A) and those without (134 patients, group B). Primary outcomes (death and subsequent aortic valve surgery) were compared between the two groups. RESULTS: At the time of mitral valve surgery, 104 patients (74%) in group A had mild aortic regurgitation, 37 (26%) had moderate aortic regurgitation, 5 had (4%) mild aortic stenosis, and 2 (1%) had moderate aortic stenosis. At the end of follow-up, no patient had severe aortic valve disease. In all, 12 patients (5%) in group A had primary events (eight deaths and four subsequent aortic valve replacements), and 12 patients (9%) in group B had such events (12 deaths). According to Kaplan-Meier analysis, neither the survival rate nor the event-free survival rate differed significantly over the follow-up period between the two groups. CONCLUSIONS: In most patients who have mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery, the long-term outcome is comparable to that of subjects without aortic valve disease at the time of mitral valve surgery. Subsequent aortic valve replacement is rarely needed after a long follow-up period.
Full Text
https://www.sciencedirect.com/science/article/pii/S0003497502038560
DOI
S0003-4975(02)03856-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
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
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165644
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