Severe aortic stenosis in surgery of acquired heart disease: long-term results

Objective. To evaluate long-term survival, physical activity, hemodynamic parameters on aortic prosthesis and cardiac remodeling after surgical treatment of severe aortic stenosis. Material and methods. In 2019, we retrospectively analyzed the results of 100 consecutive surgeries in patients with critical aortic stenosis. Appropriate surgical intervention, anesthesia, perfusion and intensive care reduced in-hospital mortality and morbidity in these patients. Ninety-eight patients were discharged. Results. The follow-up period was 7.8 (range 6.3—10.0) years. In long-term period, 6 patients died, and 10-year Kaplan-Meier survival rate was 94%. There were no redo surgeries. Dysfunction of aortic prosthesis was observed in one patient due to pannus. Twenty-five (29%) patients were assigned to functional class I, 59 (69%) — class II, and only 2 (2%) patients were assigned to class III. According to transthoracic echocardiography, maximum and mean pressure gradients were 30.5±14.1 and 16.6±9.6 mm Hg, respectively. Regression of myocardial mass and myocardial mass index was 22% and 23% compared to early postoperative data, respectively. Conclusion. In patients with severe aortic stenosis and extremely unfavorable clinical prognosis, surgical treatment remains the main method. Normalization of intracardiac hemodynamics leads to significant reverse cardiac remodeling and improves QoL and life expectancy.