Early Outcomes in Patients with Severe Dilated Left Ventricle Disease
after Heart Valve Surgery
Abstract
Objectives: The study sought to examine the prognostic impact of
valvular surgery in patients with severe dilated left ventricle(DL) and
assess morphological and functional changes of DL in the early period
after operation. Methods: From January 2013 to December 2018, at a
single center, 126 patients with severe dilated left ventricle (DL
group) and 511 patients with 511 patients with normal sized left
ventricle (NL group) underwent heart valve surgery. Retrospective review
of the procedure and the postoperative clinical course, including
echocardiography were analyzed in 6 to 12-month follow up. Results:
Compared with NL group, DL group had significantly higher postoperative
all-cause mortality (3.2% vs 1.4%) and complication rate, as well as
longer duration of mechanical ventilation and vasoactive agents support.
In DL group, 4 (3.2%) patients died in the early postoperative stage
among which 2 (1.6%) patients died from multiple organ failure (MOF)
secondary to severe low-output syndrome, 2 (1.6%) patients died from
ventricular fibrillation. The DL group had longer time of mechanical
ventilation and vasoactive agents support than NL group postoperatively.
In DL group, the progressive regression of end-diastole diameter (LVEDD)
was observed during the follow-up; whereas left ventricular ejection
function (LVEF) and left ventricular fractional shortening (LVFS) showed
a temporary decrease in early postoperative stage and then improved
gradually. Conclusion: Heart valve surgery performed in an experienced
center, along with sophisticated perioperative management, could bring
satisfying early outcomes to patients with severe dilated left
ventricle.