초록접수 현황
| 14F-206 | 구연 발표 |
Long-term Outcomes of Patients with Paradoxical Low Gradient Severe Aortic Stenosis Despite Preserved Left Ventricular Ejection Fraction
Kwan Wook Kim, Seung Hyun Lee, Young-Nam Youn, Kyung-Jong Yoo, Byung-Chul Chang, Sak Lee
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine
Background : Paradoxical aortic stenosis(AS) is defined as severe AS(aortic valve area<1.0cm2) with low mean gradient(<40mmHg), preserved LV ejection fraction(≥50%). The objective of this study was to compare the long-term outcomes of paradoxical AS with non-paradoxical AS.
Methods : From January, 2000 to December, 2013. 291 patients underwent isolated AVR with severe AS. Of these, paradoxical AS patients were 24 (Group A) and non-paradoxical AS patients were 267 (Group B). Pre- and postoperative echocardiographic values for LV remodeling and overall survival rate were compared between groups.
Results : Mean follow up duration was 5.4years. Preoperatively, group A had larger AVA index (0.52cm2/m2 vs 0.39cm2/m2, P<0.01) and lower LV mass index (126.1g/m2 vs 157.4g/m2, p<0.01). Postoperatively, group A showed reduced LV remodeling patterns as following; 1) LV mass index (-8.9g/m2 vs -39.9 g/m2, P<0.01), 2) LV ejection fraction (-4.8 % vs +4.5%, p<0.01). But, there was no significant difference in overall survival rate between groups (12.5% vs 8.2%, p=0.45).
Conclusion : Overall survival rate was similar between groups. But in the paradoxical AS group showed adverse influence on LV remodeling in terms of LV ejection fraction and LV mass index changes. Therefore, we need more careful postoperative monitoring and medical treatment in this categorical patients.
Methods : From January, 2000 to December, 2013. 291 patients underwent isolated AVR with severe AS. Of these, paradoxical AS patients were 24 (Group A) and non-paradoxical AS patients were 267 (Group B). Pre- and postoperative echocardiographic values for LV remodeling and overall survival rate were compared between groups.
Results : Mean follow up duration was 5.4years. Preoperatively, group A had larger AVA index (0.52cm2/m2 vs 0.39cm2/m2, P<0.01) and lower LV mass index (126.1g/m2 vs 157.4g/m2, p<0.01). Postoperatively, group A showed reduced LV remodeling patterns as following; 1) LV mass index (-8.9g/m2 vs -39.9 g/m2, P<0.01), 2) LV ejection fraction (-4.8 % vs +4.5%, p<0.01). But, there was no significant difference in overall survival rate between groups (12.5% vs 8.2%, p=0.45).
Conclusion : Overall survival rate was similar between groups. But in the paradoxical AS group showed adverse influence on LV remodeling in terms of LV ejection fraction and LV mass index changes. Therefore, we need more careful postoperative monitoring and medical treatment in this categorical patients.
책임저자: 이삭
연세대학교 의과대학 심장혈관병원 흉부외과학교실
연락처 : 김관욱, Tel: 02-2228-8493 , E-mail : mujin10km@yuhs.ac
