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Natural history of mild aortic valve disease untreated at the time of rheumatic mitral valve replacement

DC Field Value Language
dc.contributor.authorKim, DJ-
dc.contributor.authorJoo, HC-
dc.contributor.authorLee, SH-
dc.contributor.authorChang, BC-
dc.contributor.authorLee, S-
dc.date.accessioned2020-01-09T06:41:19Z-
dc.date.available2020-01-09T06:41:19Z-
dc.date.issued2018-
dc.identifier.issn1569-9293-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17962-
dc.description.abstractOBJECTIVES: The aim of this study was to examine long-term clinical outcomes and to assess the eventual need for aortic valve replacement (AVR) in patients with mild aortic valve disease (AVD) at the time of mitral valve replacement.
METHODS: Between 1990 and 2015, 1231 patients undergoing mitral valve replacement were reviewed, stratifying subjects as those with AVD (n = 363) or without AVD (NA; n = 868). Primary end points were progressive AVD (grade ≥ II) and subsequent AVR. Overall mortality and valve-related complications served as secondary end points. Propensity score matching was used for risk adjustment (n = 320 in each group).
RESULTS: No differences in postoperative complications or clinical outcomes were observed between groups. The 20-year overall survival was similar (before matching: NA 86.1% vs AVD 80.8%, P = 0.128; after matching: 83.5% vs 81.1%, P = 0.425). Of the entire cohort, progressive AVD was observed in 162 patients, and significant AVD (grade ≥ III) was observed in only 60 patients. Subsequent AVR was required in 37 patients due to mitral valve (MV) dysfunction or severe aortic stenosis. The 20-year freedom from significant AVD and subsequent AVR was significantly higher in the NA group than in the AVD group before and after matching (before: NA, 96.5% vs 73.7%, P < 0.001; AVD, 98.5% vs 82.3%, P < 0.001; after: 98.1% vs 73.3%, P < 0.001; 99.3% vs 82.5%, P < 0.001, respectively).
CONCLUSIONS: Although progressive AVD did not significantly impact long-term survival during the follow-up period, those patients qualifying initially as mild AVD may eventually progress to significant AVD after the first 5 postoperative years. Therefore, aggressive echocardiography should be performed at 5-year lapse after mitral valve replacement to determine the appropriate timing of AVR.
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dc.language.isoen-
dc.subject.MESHAged-
dc.subject.MESHAortic Valve-
dc.subject.MESHAortic Valve Stenosis-
dc.subject.MESHEchocardiography-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHForecasting-
dc.subject.MESHHeart Valve Prosthesis Implantation-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMitral Valve-
dc.subject.MESHPostoperative Complications-
dc.subject.MESHPropensity Score-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRheumatic Heart Disease-
dc.subject.MESHSurvival Rate-
dc.titleNatural history of mild aortic valve disease untreated at the time of rheumatic mitral valve replacement-
dc.typeArticle-
dc.identifier.pmid29873732-
dc.subject.keywordAortic valve disease-
dc.subject.keywordRheumatic heart disease-
dc.subject.keywordMitral valve replacement-
dc.contributor.affiliatedAuthor김, 도정-
dc.type.localJournal Papers-
dc.identifier.doi10.1093/icvts/ivy176-
dc.citation.titleInteractive cardiovascular and thoracic surgery-
dc.citation.volume27-
dc.citation.number6-
dc.citation.date2018-
dc.citation.startPage828-
dc.citation.endPage835-
dc.identifier.bibliographicCitationInteractive cardiovascular and thoracic surgery, 27(6). : 828-835, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1569-9285-
dc.relation.journalidJ015699293-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Thoracic & Cardiovascular Surgery
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