Aortic Valve Replacement for Low-Flow/Low-Gradient Aortic Stenosis

• Published in: Journal of the American College of Cardiology 2008-04, Vol.51 (15), p.1466-1472
• Main Authors: Levy, Franck, MD, Laurent, Marcel, MD, Monin, Jean Luc, MD, Maillet, Jean Michel, MD, Pasquet, Agnès, MD, Le Tourneau, Thierry, MD, Petit-Eisenmann, Hélène, MD, Gori, Mauro, MD, Jobic, Yannick, MD, Bauer, Fabrice, MD, Chauvel, Christophe, MD, Leguerrier, Alain, MD, PhD, Tribouilloy, Christophe, MD, PhD, FACC
• Format: Article
• Language: English
• Subjects: Cardiovascular; Internal Medicine
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2007.10.067

Aortic Valve Replacement for Low-Flow/Low-Gradient Aortic Stenosis: Operative Risk Stratification and Long-Term Outcome: A European Multicenter Study Franck Levy, Marcel Laurent, Jean Luc Monin, Jean Michel Maillet, Agnès Pasquet, Thierry Le Tourneau, Hélène Petit-Eisenmann, Mauro Gori, Yannick Jobic, Fabrice Bauer, Christophe Chauvel, Alain Leguerrier, Christophe Tribouilloy Few large studies are available concerning the results of surgery in low-flow/low-gradient aortic stenosis (LF/LGAS). We evaluated 217 consecutive patients with LF/LGAS who underwent aortic valve replacement (AVR) in 11 European centers between 1990 and 2005. Perioperative mortality decreased from 20% in the 1990 to 1999 period to 10% (p = 0.04) in the 2000 to 2005 period. European System for Cardiac Operative Risk Evaluation score (p = 0.02), absence of contractile reserve on dobutamine echocardiography, multivessel coronary artery disease (p = 0.01), and pre-operative mean gradient (p = 0.007) were associated with perioperative mortality. In view of the poor spontaneous prognosis and the current operative risk, AVR is the treatment of choice in the majority of cases of LF/LGAS.