Is it ever worth contemplating an aortic valve replacement on patients with low gradient severe aortic stenosis but poor left ventricular function with no contractile reserve?

Interactive Cardiovascular and Thoracic Surgery

Volumn 7, Issue 2, 2008, Pages 301-305

  Subramanian, Hariharan ^b   Kunadian, Babu ^a   Dunning, Joel ^b  

^a HAHNEMANN UNIVERSITY HOSPITAL   (United States)

^b JAMES COOK UNIVERSITY HOSPITAL   (United Kingdom)

Author keywords

Aortic valve stenosis; Congestive heart failure; Evidence based medicine; Thoracic surgery

Indexed keywords

BRAIN NATRIURETIC PEPTIDE; DOBUTAMINE;

AORTA STENOSIS; AORTA VALVE REPLACEMENT; ARTICLE; DISEASE SEVERITY; EVIDENCE BASED PRACTICE; EXERCISE TEST; HEART EJECTION FRACTION; HEART LEFT VENTRICLE FUNCTION; HEART STROKE VOLUME; HIGH RISK PATIENT; HUMAN; LUNG EDEMA; OUTCOME ASSESSMENT; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROGNOSIS; STRESS ECHOCARDIOGRAPHY; SURGICAL MORTALITY; SURVIVAL;

ADRENERGIC BETA-AGONISTS; AGED; AORTIC VALVE STENOSIS; BENCHMARKING; DOBUTAMINE; EVIDENCE-BASED MEDICINE; EXERCISE TEST; HEART TRANSPLANTATION; HEART VALVE PROSTHESIS IMPLANTATION; HUMANS; MALE; MYOCARDIAL CONTRACTION; PATIENT SELECTION; PRACTICE GUIDELINES AS TOPIC; SEVERITY OF ILLNESS INDEX; TREATMENT OUTCOME; VENTRICULAR FUNCTION, LEFT;

EID: 41849083744     PISSN: 15699293     EISSN: None     Source Type: Journal    
DOI: 10.1510/icvts.2008.175463     Document Type: Article

References (9)

1. Dunning J, Prendergast B, Mackway-Jones K. Towards evidence-based medicine in cardiothoracic surgery: best BETS. Interact Cardiovasc Thorac Surg 2003;2:405-409.
2. deFilippi CR, Willett DL, Brickner ME, Appleton CP, Yancy CW, Eichhorn EJ, Grayburn PA. Usefulness of dobutamine echocardiography in distinguishing severe from nonsevere valvular aortic stenosis in patients with depressed left ventricular function and low transvalvular gradients. Am J Cardiol 1995;75:191-194.
3. Monin JL, Monchi M, Gest V, Duval-Moulin AM, Dubois-Rande JL, Gueret P. Aortic stenosis with severe left ventricular dysfunction and low transvalvular pressure gradients: risk stratification by low-dose dobutamine echocardiography. J Am Coll Cardiol 2001;37:2101-2107.
4. Monin JL, Quere JP, Monchi M, Petit H, Baleynaud S, Chauvel C, Pop C, Ohlmann P, Lelguen C, Dehant P, Tribouilloy C, Gueret P. Low-gradient aortic stenosis: operative risk stratification and predictors for longterm outcome: a multicenter study using dobutamine stress hemodynamics. wsee commentx. Circulation 2003;108:319-324.
5. Quere JP, Monin JL, Levy F, Petit H, Baleynaud S, Chauvel C, Pop C, Ohlmann P, Lelguen C, Dehant P, Gueret P, Tribouilloy C. Influence of preoperative left ventricular contractile reserve on postoperative ejection fraction in low-gradient aortic stenosis. [see comment]. Circulation 2006;113:1738-1744.
6. Nishimura RA, Grantham JA, Connolly HM, Schaff HV, Higano ST, Holmes DR Jr. Low-output, low-gradient aortic stenosis in patients with depressed left ventricular systolic function: the clinical utility of the dobutamine challenge in the catheterization laboratory. [see comment]. Circulation 2002;106:809-813.
7. Bergler-Klein J, Mundigler G, Pibarot P, Burwash IG, Dumesnil JG, Blais C, Fuchs C, Mohty D, Beanlands RS, Hachicha Z, Walter-Publig N, Rader F, Baumgartner H. B-type natriuretic peptide in low-flow, low-gradient aortic stenosis: relationship to hemodynamics and clinical outcome: results from the Multicenter Truly or Pseudo-Severe Aortic Stenosis (TOPAS) study. Circulation 2007;115:2848-2855.
8. American College of Cardiology/American Heart Association Task Force on Practice Guidelines, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, Bonow RO, Carabello BA, Kanu C, de LA Jr, Faxon DP, Freed MD, Gaasch WH, Lytle BW, Nishimura RA, O'Gara PT, O'Rourke RA, Otto CM, Shah PM, Shanewise JS, Smith SC Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Faxon DP, Fuster V, Halperin JL, Hiratzka LF, Hunt SA, Lytle BW, Nishimura R, Page RL, Riegel B. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. [Review] [1066 refs]. Circulation 2006;114:e84-231.
9. Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, Flachskampf F, Hall R, Iung B, Kasprzak J, Nataf P, Tornos P, Torracca L, Wenink A, Task Force on the Management of Valvular Hearth Disease of the European Society of Cardiology, ESC Committee for Practice Guidelines. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 2007;28:230-268.