Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?

Jong Won Ha, Seung Hyuck Choi, Byung Chul Chang, Chung Mo Nam, Yangsoo Jang, Namsik Chung, Won Heum Shim, Seung Yun Cho, Sung Soon Kim

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background. Determining the need for surgical treatment of coexisting mild to moderate aortic valve disease in patients referred for mitral valve surgery is often difficult. The purpose of this study was to assess long-term clinical outcome and the need for subsequent aortic valve replacement in patients with mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery. Methods. A total of 275 patients (90 men and 185 women, mean age 43 years) with rheumatic disease who underwent mitral valve surgery were followed up for an average of 9 years. Patients were classified into two groups: those with coexisting mild to moderate aortic valve disease at the time of mitral valve surgery (141 patients, group A) and those without (134 patients, group B). Primary outcomes (death and subsequent aortic valve surgery) were compared between the two groups. Results. At the time of mitral valve surgery, 104 patients (74%) in group A had mild aortic regurgitation, 37 (26%) had moderate aortic regurgitation, 5 had (4%) mild aortic stenosis, and 2 (1%) had moderate aortic stenosis. At the end of follow-up, no patient had severe aortic valve disease. In all, 12 patients (5%) in group A had primary events (eight deaths and four subsequent aortic valve replacements), and 12 patients (9%) in group B had such events (12 deaths). According to Kaplan-Meier analysis, neither the survival rate nor the event-free survival rate differed significantly over the follow-up period between the two groups. Conclusions. In most patients who have mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery, the long-term outcome is comparable to that of subjects without aortic valve disease at the time of mitral valve surgery. Subsequent aortic valve replacement is rarely needed after a long follow-up period.

Original languageEnglish
Pages (from-to)1115-1119
Number of pages5
JournalAnnals of Thoracic Surgery
Volume74
Issue number4
DOIs
Publication statusPublished - 2002 Oct 1

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Aortic Diseases
Aortic Valve
Mitral Valve
Aortic Valve Insufficiency
Aortic Valve Stenosis
Survival Rate
Kaplan-Meier Estimate
Rheumatic Diseases
Disease-Free Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Ha, Jong Won ; Choi, Seung Hyuck ; Chang, Byung Chul ; Nam, Chung Mo ; Jang, Yangsoo ; Chung, Namsik ; Shim, Won Heum ; Cho, Seung Yun ; Kim, Sung Soon. / Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?. In: Annals of Thoracic Surgery. 2002 ; Vol. 74, No. 4. pp. 1115-1119.
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title = "Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?",
abstract = "Background. Determining the need for surgical treatment of coexisting mild to moderate aortic valve disease in patients referred for mitral valve surgery is often difficult. The purpose of this study was to assess long-term clinical outcome and the need for subsequent aortic valve replacement in patients with mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery. Methods. A total of 275 patients (90 men and 185 women, mean age 43 years) with rheumatic disease who underwent mitral valve surgery were followed up for an average of 9 years. Patients were classified into two groups: those with coexisting mild to moderate aortic valve disease at the time of mitral valve surgery (141 patients, group A) and those without (134 patients, group B). Primary outcomes (death and subsequent aortic valve surgery) were compared between the two groups. Results. At the time of mitral valve surgery, 104 patients (74{\%}) in group A had mild aortic regurgitation, 37 (26{\%}) had moderate aortic regurgitation, 5 had (4{\%}) mild aortic stenosis, and 2 (1{\%}) had moderate aortic stenosis. At the end of follow-up, no patient had severe aortic valve disease. In all, 12 patients (5{\%}) in group A had primary events (eight deaths and four subsequent aortic valve replacements), and 12 patients (9{\%}) in group B had such events (12 deaths). According to Kaplan-Meier analysis, neither the survival rate nor the event-free survival rate differed significantly over the follow-up period between the two groups. Conclusions. In most patients who have mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery, the long-term outcome is comparable to that of subjects without aortic valve disease at the time of mitral valve surgery. Subsequent aortic valve replacement is rarely needed after a long follow-up period.",
author = "Ha, {Jong Won} and Choi, {Seung Hyuck} and Chang, {Byung Chul} and Nam, {Chung Mo} and Yangsoo Jang and Namsik Chung and Shim, {Won Heum} and Cho, {Seung Yun} and Kim, {Sung Soon}",
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Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease? / Ha, Jong Won; Choi, Seung Hyuck; Chang, Byung Chul; Nam, Chung Mo; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun; Kim, Sung Soon.

In: Annals of Thoracic Surgery, Vol. 74, No. 4, 01.10.2002, p. 1115-1119.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Is prophylactic aortic valve replacement indicated during mitral valve surgery for mild to moderate aortic valve disease?

AU - Ha, Jong Won

AU - Choi, Seung Hyuck

AU - Chang, Byung Chul

AU - Nam, Chung Mo

AU - Jang, Yangsoo

AU - Chung, Namsik

AU - Shim, Won Heum

AU - Cho, Seung Yun

AU - Kim, Sung Soon

PY - 2002/10/1

Y1 - 2002/10/1

N2 - Background. Determining the need for surgical treatment of coexisting mild to moderate aortic valve disease in patients referred for mitral valve surgery is often difficult. The purpose of this study was to assess long-term clinical outcome and the need for subsequent aortic valve replacement in patients with mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery. Methods. A total of 275 patients (90 men and 185 women, mean age 43 years) with rheumatic disease who underwent mitral valve surgery were followed up for an average of 9 years. Patients were classified into two groups: those with coexisting mild to moderate aortic valve disease at the time of mitral valve surgery (141 patients, group A) and those without (134 patients, group B). Primary outcomes (death and subsequent aortic valve surgery) were compared between the two groups. Results. At the time of mitral valve surgery, 104 patients (74%) in group A had mild aortic regurgitation, 37 (26%) had moderate aortic regurgitation, 5 had (4%) mild aortic stenosis, and 2 (1%) had moderate aortic stenosis. At the end of follow-up, no patient had severe aortic valve disease. In all, 12 patients (5%) in group A had primary events (eight deaths and four subsequent aortic valve replacements), and 12 patients (9%) in group B had such events (12 deaths). According to Kaplan-Meier analysis, neither the survival rate nor the event-free survival rate differed significantly over the follow-up period between the two groups. Conclusions. In most patients who have mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery, the long-term outcome is comparable to that of subjects without aortic valve disease at the time of mitral valve surgery. Subsequent aortic valve replacement is rarely needed after a long follow-up period.

AB - Background. Determining the need for surgical treatment of coexisting mild to moderate aortic valve disease in patients referred for mitral valve surgery is often difficult. The purpose of this study was to assess long-term clinical outcome and the need for subsequent aortic valve replacement in patients with mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery. Methods. A total of 275 patients (90 men and 185 women, mean age 43 years) with rheumatic disease who underwent mitral valve surgery were followed up for an average of 9 years. Patients were classified into two groups: those with coexisting mild to moderate aortic valve disease at the time of mitral valve surgery (141 patients, group A) and those without (134 patients, group B). Primary outcomes (death and subsequent aortic valve surgery) were compared between the two groups. Results. At the time of mitral valve surgery, 104 patients (74%) in group A had mild aortic regurgitation, 37 (26%) had moderate aortic regurgitation, 5 had (4%) mild aortic stenosis, and 2 (1%) had moderate aortic stenosis. At the end of follow-up, no patient had severe aortic valve disease. In all, 12 patients (5%) in group A had primary events (eight deaths and four subsequent aortic valve replacements), and 12 patients (9%) in group B had such events (12 deaths). According to Kaplan-Meier analysis, neither the survival rate nor the event-free survival rate differed significantly over the follow-up period between the two groups. Conclusions. In most patients who have mild to moderate rheumatic aortic valve disease at the time of mitral valve surgery, the long-term outcome is comparable to that of subjects without aortic valve disease at the time of mitral valve surgery. Subsequent aortic valve replacement is rarely needed after a long follow-up period.

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