Impact of left ventricular dysfunction in patients undergoing moderate to severe aortic stenosis

Objective: The objective of this study was to analyze the impact of severe left ventricular dysfunction on mortality after aortic valve replacement with and without combined coronary artery bypass graft surgery in Son Espases University Hospital. Methods: We included 666 patients undergoing aortic valve replacement from November 2000 through December 2009. Patients were clasified in two groups according to the ejection fraction (EF): <= 35% and >35%. Patients with associated severe aortic valve insufficiency or undergoing another surgical valve procedure were excluded. Mortality following discharge was calculated from data on patient life status at December 31, 2011. The effect of severe left ventricular dysfunction on mid-term mortality was analyzed with Kaplan-Meyer survival estimates and a risk-adjusted Cox proportional regression model. Results: The proportion of female sex was 42,49% (n = 283). Median age was 71,42 years (62,82 - 80,02) and median logistic Euroscore was 5,82 (3,74 - 9,15). Observed in-hospital mortality was 2,1% (n = 14). Median time of follow-up was 4,6 years, very similar in both groups. Cox regression analysis showed an association between severe left ventricular dysfunction and mid-term mortality (HR 2,55, Cl 95% 1,36 - 4,76). Conclusions: Severe left ventricular dysfunction is associated with a higher mid-term mortality in patients undergoing aortic valve replacement with and without combined coronary surgery, aortic valve.