Reassessing the Indications for Intervention in Patients with Aortic Regurgitation

New data suggest a lower left-ventricular end-systolic dimension index as a threshold for aortic valve repair or replacement.

The prognostic value of left ventricular dimensions on the benefits of aortic valve repair and replacement (AVR) is uncertain. To learn more, investigators conducted an observational study of 748 patients with at least moderate chronic aortic regurgitation (AR), who were identified by initial transthoracic echocardiogram and then followed for outcomes (mean age, 58; 18% women).

Of the cohort, 361 (48%) underwent AVR (replacement, 73%; repair, 27%). In 86%, AVR occurred within 6 months of diagnosis, most often for the Class I indication of symptoms. Only one patient died within 30 days of surgery. During a median follow-up of about 5 years, 125 patients died (after AVR, 10%; without intervention, 23%). In multivariable analysis of various ech…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)