Surgical Treatment of Aortic Regurgitation with Lower Ejection Fraction_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIXin-min , ZHUYan , ZHAOKe-yan , XIAPeng

Department of Cardiovascular Surgery, General Hospital of Shenyang Military Region, Shenyang 110016, P. R. China;

Corresponding?author：

LIXin-min, Email: lixinmin33@hotmail.com

Keywords：

Aortic regurgitation; Lower ejection fraction; Valve replacement

DOI：

10.7507/1007-4848.20150167

Video：

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Objective To summarize the surgical experience of aortic regurgitation with lower ejection fraction (EF). Methods We retrospectively analyzed the clinical data of 34 patients with aortic regurgitation and lower ejection fraction received aortic valve replacement in the General Hospital of Shenyang Military Region between January 2012 and December 2013. There were 27 males and 7 females with age of 21-74 (51.03±12.06) years. All surgical procedures were performed under general anesthesia during cardiopulmonary bypass. Results There was no operative mortality. Cardiopulmonary bypass time was 40-155 (60.92±22.89) minutes, aortic clamping time varied from 24 to 79 (37.12±12.61) minutes. Postoperative ventilator-assisted time was 4 to 67 (16.12±12.74) hours. The patients were discharged 8-15 (11.03±2.04) days after surgery. When discharged, EF value was 30% to 48% (41%±4%) and significantly improved compared with that before operation (P<0.01). Pulmonary artery systolic pressure varied from 33 to 50 (38.35±4.35) mm Hg and decreased significantly than that before operation (P<0.01). Left ventricular end-diastolic volume reduced to 168-380 (269.12±52.01) ml and obviously decreased than that before operation (P<0.01). Conclusion Surgical treatment can be carried out on patients with aortic insufficiency and lower EF. Treatment results are satisfactory.

Citation： LIXin-min, ZHUYan, ZHAOKe-yan, XIAPeng. Surgical Treatment of Aortic Regurgitation with Lower Ejection Fraction. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(7): 657-659. doi: 10.7507/1007-4848.20150167 Copy

1.	Roberts WC, Vowels TJ, Ko JM. Natural history of adults with congenitally malformed aortic valves (unicuspid or bicuspid). Medicine, 2012, 91(6):287-308.
2.	胡盛壽, 張國平, 朱曉東, 等. 巨大心臟瓣膜置換手術后遠期療效的觀察. 中華外科雜志, 1996, 34(3):164.
3.	Taniguchi K, Sawa Y. Contemporary reviews by surgeon:timing of operation for chronic aortic regurgitation. Gen Thorac Cardiovasc Surg, 2012, 60(11):735-743.
4.	徐激斌, 唐楊烽, 徐志云, 等. 主動脈瓣關閉不全合并左心室功能不全的外科治療. 中國胸心血管外科臨床雜志, 2011, 18(6):565-567.
5.	Pate R, Kamath A, Varadarajan P, et al. Slow rate of progression of grade 1 and 2+ aortic regurgitation. J Heart Valve Dis, 2012, 21(3):328-330.
6.	Maganti K, Rigolin VH, Sarano ME, et al. Valvular heart disease:diagnosis and management. Mayo Clin Proc, 2010, 85(5):483-500.
7.	Reginelli JP, Griffin B. The challenge of valvular heart disease:When is it time to operate? Cleve Clin J Med, 2004, 71(6):464-482.
8.	孫強, 張永善, 許運賓, 等. 心臟瓣膜病合并巨大左心室的外科治療. 中國胸心血管外科臨床雜志, 2005, 12(3):226.
9.	Park HW, Song JM, Choo SJ, et al. Effect of preoperative ejection fraction, left ventricular systolic dimension and hemoglobin level on survival after aortic valve surgery in patients with severe chronic aortic regurgitation. Am J Cardiol, 2012, 109(12):1782-1786.
10.	朱團結, 姚筱, 廖凡, 等. 大左心室心臟病患者術后發生室性心律失常的危險因素分析. 中國胸心血管外科臨床雜志, 2009, 16(2):110-113.
11.	于偉勇, 張寶仁, 侯明君, 等. 二尖瓣置換術后巨大左室的幾何形態學變化及其與左室收縮功能的關系. 中華胸心血管外科雜志, 2002, 18(5):267-270.
12.	邱志兵, 陳鑫, 徐明, 等. 巨大左心室心臟瓣膜置換術后左心室重構的臨床觀察. 中國胸心血管外科臨床雜志, 2006, 13(3):155-157.
13.	覃俊安, 黃小龍, 吳西林, 等. 心臟瓣膜病合并巨大左心室的外科治療療效觀察. 第四軍醫大學學報, 2008, 29(19):封3-01.
14.	于偉勇, 張寶仁, 梅舉, 等. 巨大左心室患者心臟瓣膜手術的圍術期特點及其處理. 第二軍醫大學學報, 1999, 20(12):1018-1020.
15.	Mokadam NA, Stout KK, Verrier ED. Management of acute regurgitation in left-sided cardiac valves. Tex Heart Inst J, 2011, 38(1):9-19.
16.	Ren X, Banki NM. Classic hemodynamic findings of severe aortic regurgitation. Circulation, 2012, 126(3):e28-e29.
17.	Hamirani YS, Diet CA, Voyles W, et al. Acute aortic regurgitation. Circulation, 2012, 126(9):1121-1126.
18.	Corti R, Binggeli C, Turina M, et al. Predictors of long-term survival after valve replacement for chronic aortic regurgitation. Is M-mode echocardiography sufficient? Eur Heart J, 2001, 22(10):866-873.

1. Roberts WC, Vowels TJ, Ko JM. Natural history of adults with congenitally malformed aortic valves (unicuspid or bicuspid). Medicine, 2012, 91(6):287-308.
2. 胡盛壽, 張國平, 朱曉東, 等. 巨大心臟瓣膜置換手術后遠期療效的觀察. 中華外科雜志, 1996, 34(3):164.
3. Taniguchi K, Sawa Y. Contemporary reviews by surgeon:timing of operation for chronic aortic regurgitation. Gen Thorac Cardiovasc Surg, 2012, 60(11):735-743.
4. 徐激斌, 唐楊烽, 徐志云, 等. 主動脈瓣關閉不全合并左心室功能不全的外科治療. 中國胸心血管外科臨床雜志, 2011, 18(6):565-567.
5. Pate R, Kamath A, Varadarajan P, et al. Slow rate of progression of grade 1 and 2+ aortic regurgitation. J Heart Valve Dis, 2012, 21(3):328-330.
6. Maganti K, Rigolin VH, Sarano ME, et al. Valvular heart disease:diagnosis and management. Mayo Clin Proc, 2010, 85(5):483-500.
7. Reginelli JP, Griffin B. The challenge of valvular heart disease:When is it time to operate? Cleve Clin J Med, 2004, 71(6):464-482.
8. 孫強, 張永善, 許運賓, 等. 心臟瓣膜病合并巨大左心室的外科治療. 中國胸心血管外科臨床雜志, 2005, 12(3):226.
9. Park HW, Song JM, Choo SJ, et al. Effect of preoperative ejection fraction, left ventricular systolic dimension and hemoglobin level on survival after aortic valve surgery in patients with severe chronic aortic regurgitation. Am J Cardiol, 2012, 109(12):1782-1786.
10. 朱團結, 姚筱, 廖凡, 等. 大左心室心臟病患者術后發生室性心律失常的危險因素分析. 中國胸心血管外科臨床雜志, 2009, 16(2):110-113.
11. 于偉勇, 張寶仁, 侯明君, 等. 二尖瓣置換術后巨大左室的幾何形態學變化及其與左室收縮功能的關系. 中華胸心血管外科雜志, 2002, 18(5):267-270.
12. 邱志兵, 陳鑫, 徐明, 等. 巨大左心室心臟瓣膜置換術后左心室重構的臨床觀察. 中國胸心血管外科臨床雜志, 2006, 13(3):155-157.
13. 覃俊安, 黃小龍, 吳西林, 等. 心臟瓣膜病合并巨大左心室的外科治療療效觀察. 第四軍醫大學學報, 2008, 29(19):封3-01.
14. 于偉勇, 張寶仁, 梅舉, 等. 巨大左心室患者心臟瓣膜手術的圍術期特點及其處理. 第二軍醫大學學報, 1999, 20(12):1018-1020.
15. Mokadam NA, Stout KK, Verrier ED. Management of acute regurgitation in left-sided cardiac valves. Tex Heart Inst J, 2011, 38(1):9-19.
16. Ren X, Banki NM. Classic hemodynamic findings of severe aortic regurgitation. Circulation, 2012, 126(3):e28-e29.
17. Hamirani YS, Diet CA, Voyles W, et al. Acute aortic regurgitation. Circulation, 2012, 126(9):1121-1126.
18. Corti R, Binggeli C, Turina M, et al. Predictors of long-term survival after valve replacement for chronic aortic regurgitation. Is M-mode echocardiography sufficient? Eur Heart J, 2001, 22(10):866-873.

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