Severe aortic regurgitation and reduced left ventricular ejection fraction: outcomes after isolated aortic valve replacement and combined surgery.

BACKGROUND: In patients with severe aortic regurgitation and reduced left ventricular ejection fraction (LVEF), uncertainty remains whether to recommend aortic valve replacement (AVR) over heart transplantation, especially when mitral regurgitation and/or coronary heart disease coexist.

METHODS: We assessed outcomes in 26 consecutive AVR patients aged
RESULTS: The difference in mortality and morbidity between the groups was 10% vs 6%, which was not significant (p = 0.6 in both cases). Also observed was a significant improvement in functional class and a reduction in LV end-diastolic diameter from a median value of 69 to 64 mm in the isolated AVR group and to 66 mm in the combined group (p < 0.05).

CONCLUSIONS: AVR in patients with symptomatic severe aortic regurgitation and reduced LVEF is feasible, even in the presence of concomitant mitral regurgitation and/or coronary heart disease requiring a combined surgical procedure.