Influence of Preoperative Left Ventricular Contractile Reserve on Postoperative Ejection Fraction in Low-Gradient Aortic Stenosis

• DOI: 10.1161/circulationaha.105.568824
• Publication Date: 2006-04-04T00:34:19Z
• Authors: Jean-Paul Quere; Jean-Luc Monin; Franck Levy; Hélène Petit; Serge Baleynaud; Christophe Chauvel; Camélia Pop; Patrick Ohlmann; Claude Lelguen; Patrick Dehant; Pascal Gueret; Christophe Tribou...
• Keywords: valvular heart disease

Dobutamine stress hemodynamics (DSH) has the potential to stratify operative risk in low-gradient aortic stenosis (AS), but little is known about relation between left ventricle contractile reserve and postoperative ventricular ejection fraction (LVEF). We sought assess value of DSH predict improvement LVEF.Sixty-six consecutive patients with symptomatic severe AS (aortic valve area < or =1 cm2), LVEF =40%, mean pressure gradient =40 mm Hg prospectively enrolled French multicenter study on who survived valvular replacement (AVR) were included. Preoperative was present 46 (group I; 70%) absent 20 II; 30%). In overall sample, 58% improved by 2 New York Heart Association (NYHA) classes after AVR. Mean from 29+/-6% 47+/-11% (P<0.0001). > =10 EF units 38 (83%) group I 13 (65%) II. similar groups (19+/-10% versus 17+/-11%; P=0.54). On multivariable analysis, multivessel coronary artery disease (P=0.05) baseline transaortic (P=0.01) related improvement, whereas not.LVEF increases majority survive Although absence high mortality, it does not recovery surviving These data further support concept that surgery should be contraindicated basis alone.