CHẨN ĐOÁn và ĐIỀu trị HỞ van 2 LÁ Trưởng ban soạn thảo: pgs. Ts. Bs. Đỗ Doãn Lợi Các ủy viên

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5.3. Hở van 2 lá do bệnh tim thiếu máu cục bộ
TÀI LIỆU THAM KHẢO

5.2. Hở van 2 lá cấp tính
‒ Những bệnh nhân hở van 2 lá nặng cấp tính luon có những triệu chứng cơ năng nặng nề. Khám lâm sàng ở mỏm tim thường dễ bỏ sót, do thất trái với kích thước bình thường không hề gây mỏm tim đập tăng động. Tiếng thổi tâm thu do hở van 2 lá cấp tính nhiều khi không kéo dài hết thì tâm thu thậm chí có lúc không nghe thấy. Siêu âm tim qua thành ngực có thể thấy hình ảnh rách van 2 lá, hở van 2 lá mức độ nhiều… tuy nhiên siêu âm tim qua thành ngực có thể đánh giá không đầy đủ tổn thương do không ghi nhận được hết dòng màu; do vậy siêu âm tim qua thực quản nên được tiến hành nếu vẫn còn nghi ngờ về hình thái van 2 lá và mức độ hở van. Siêu âm tim qua thực quản cũng giúp phát hiện nguyên nhân về giải phẫu gây hở van 2 lá, từ đó quyết định phương hướng điều trị.
‒ Đối với những bệnh nhân hở van 2 lá nặng cấp tính, điều trị nội khoa chỉ có vai trò hạn chế và mục đích chủ yếu chỉ nhằm vào việc ổn định huyết động trong khi chờ mổ. Nếu huyết áp trung bình động mạch vẫn trong giới hạn bình thường, sử dụng các thuốc hạ hậu gánh có thể làm ổn định tình trạng HoHL cấp. Truyền tĩnh mạch Nitroprusside và Nitroglycerin làm giảm áp lực mạch phổi, giảm ứ huyết phổi và tăng cường thể tích tống máu. Nếu chưa cần phẫu thuật ngay, có thể chuyển sang dạng thuoc uống, phối hợp thuốc ức chế men chuyển và Hydralazin. Nếu tụt huyết áp, không nên dùng Nitroprusside đơn thuần mà nên phối hợp với một thuốc vận mạch (như Dobutamine). Trong những trường hợp hở van 2 lá nặng, cấp (mà thất trái chưa kịp dãn, phì đại như HoHL do đứt cột cơ nhú sau nhồi máu cơ tim) nếu xuất hiện triệu chứng phù phổi, sốc tim, tụt huyết áp thì nên đặt bóng trong động mạch chủ với tác dụng tăng thể tích tống máu, tăng huyết áp trung bình động mạch, giảm thể tích dòng hở, giảm áp lực đổ đầy thất trái để ổn định tình trạng huyết động trong khi chờ mổ. Nếu nguyên nhân gây hở van 2 lá cấp là viêm nội tâm mạc thì việc xác định căn nguyên cũng như dùng kháng sinh kịp thời là quan trọng nhất trong điều trị.
‒ Điều trị ngoại khoa đa số bệnh nhân HoHL nặng, cấp tính đều phải mổ cấp cứu. Tùy theo nguyên nhân và hình thái tổ chức bộ máy van 2 lá mà phẫu thuật mổ sửa van hay thay van 2 lá.
5.3. Hở van 2 lá do bệnh tim thiếu máu cục bộ
Tiên lượng chung của những bệnh nhân hở van 2 lá do bệnh tim thiếu máu cục bộ xấu hơn đáng kể so với các bệnh nhân hở van 2 lá do nguyên nhân khác ^{[63, 64]} do hở van 2 lá gây ra bởi rối loạn chức năng thất trái hậu quả của nhồi máu cơ tim và do rối loạn hoạt động của dây chằng cột cơ và co kéo lá van 2 lá.
Chỉ định phẫu thuật van 2 lá ở bệnh nhân mổ bắc cầu chủ vành có kèm hở hai lá nhẹvừa vẫn chưa rõ ràng mặc dù có một số nghiên cứu chứng minh kết quả tốt sau khi sửa van 2 lá ở nhóm bệnh nhân này^[65‒68]: nên chỉ định sửa van 2 lá cùng lúc với mổ bắc cầu nối chủ vành^[65‒79]. Trong trường hợp hở van 2 lá nặng thứ phát do nhồi máu cơ tim cấp, thường xuất hiện tụt huyết áp hoặc phù phổi cấp. Hở van 2 lá nặng thường xảy ra trong 6‒7% bệnh nhân có sốc tim^[80]. Nguyên nhân gây hở van 2 lá cần được xác định rõ: có thể do đứt cơ nhú, rối loạn hoạt động dây chằng gây sa lá van hoặc do dãn vòng van vì thất trái dãn nặng. Những bệnh nhân đứt cơ nhú cấp tính cần được phẫu thuật cấp cứu sửa van hoặc thay van 2 la^[81] . Nếu hở van 2 lá do rối loạn hoạt động của cơ nhú thì điều trị ban đầu cần làm ổn định huyết động ngay, thường phải bằng đặt bóng trong động mạch chủ. Nếu điều trị nội khoa tích cực không làm cải thiện triệu chứng lâm sàng thì cần chỉ định mổ cấp cứu. Phẫu thuật điều trị hở van 2 lá cấp tính thường bao gồm phẫu thuật bắc cầu nối chủ vành để điều trị tái tạo ĐMV kết hợp với phẫu thuật van 2 lá (thường là sửa van 2 lá có đặt vòng van)^{[65, 68, 70‒79]}.

TÀI LIỆU THAM KHẢO
1. Gorlin R, Gorlin SG. Hydraulic formula for calculation of the area of the stenotic mitral valve, other cardiac valves, and central circulatory shunts. Am Heart J 1951;41:1–29.
2. Snopek G, Pogorzelska H, Rywik TM, Browarek A, Janas J, Korewicki J. Usefulness of endothelin‒1 concentration in capillary blood in patients with mitral stenosis as a predictor of regression of pulmonary hypertension after mitral valve replacement or valvuloplasty. Am J Cardiol 2002;90:188 –9
3. Roberts WC, Perloff JK. Mitral valvular disease. A clinicopathologic survey of the conditions causing the mitral valve to function abnormally. Ann Intern Med 1972;77:939 –75
4. Rusted IE, Scheifley CH, Edwards JE. Studies of the mitral valve. II. Certain anatomic features of the mitral valve and associated structures in mitral stenosis. Circulation 1956;14:398–406
5. Wood P. An appreciation of mitral stenosis. I. Clinical features. Br Med J 1954;4870:1051– 63
6. Rowe JC, Bland EF, Sprague HB, White PD. The course of mitral stenosis without surgery: ten‒ and twenty‒year perspectives. Ann Intern Med 1960;52:741–9.
7. Olesen KH. The natural history of 271 patients with mitral stenosis under medical treatment.
Br Heart J 1962;24:349 –57
8. Selzer A, Cohn KE. Natural history of mitral stenosis: a review. Circulation 1972;45:878 –90
9. Hatle L, Brubakk A, Tromsdal A, Angelsen B. Noninvasive assessment of pressure drop in mitral stenosis by Doppler ultrasound. Br Heart J 1978;40:131– 40.
10. Hatle L, Angelsen B, Tromsdal A. Noninvasive assessment of atrioventricular pressure halftime by Doppler ultrasound. Circulation 1979;60: 1096–104
11. Currie PJ, Seward JB, Chan KL, et al. Continuous wave Doppler determination of right ventricular pressure: a simultaneous Dopplercatheterization study in 127 patients. J Am Coll Cardiol 1985;6:750–6
12. Laupacis A, Albers G, Dunn M, Feinberg W. Antithrombotic therapy in atrial fibrillation. Chest 1992;102:426S–33S
13. Manning WJ, Silverman DI, Keighley CS, Oettgen P, Douglas PS. Transesophageal echocardiographically facilitated early cardioversion from atrial fibrillation using short‒term anticoagulation: final results of a prospective 4.5‒year study. J Am Coll Cardiol 1995;25:1354– 61
14. Daley R, Mattingly TW, Holt CL, Bland EF, White PD. Systemic arterial embolism in rheumatic heart disease. Am Heart J 1951;42:566–81
15. Nakatani S, Masuyama T, Kodama K, Kitabatake A, Fujii K, Kamada T. Value and limitations of Doppler echocardiography in the quantification of stenotic mitral valve area: comparison of the pressure half‒time and the continuity equation methods. Circulation 1988;77:78–85
16. Thomas JD, Wilkins GT, Choong CY, et al. Inaccuracy of mitral pressure half‒time immediately after percutaneous mitral valvotomy. Dependence on transmitral gradient and left atrial and ventricular compliance. Circulation 1988;78:980 –93
17. Rediker DE, Block PC, Abascal VM, Palacios IF. Mitral balloon valvuloplasty for mitral restenosis after surgical commissurotomy. J Am Coll Cardiol 1988;11:252– 6
18. Jang IK, Block PC, Newell JB, Tuzcu EM, Palacios IF. Percutaneous mitral balloon valvotomy for recurrent mitral stenosis after surgical commissurotomy. Am J Cardiol 1995;75:601–5.
19. Rangel A, Chavez E, Murillo H, Ayala F. Immediate results of the Inoue mitral valvotomy in patients with previous surgical mitral commissurotomy. Preliminary report. Arch Med Res 1998;29:159–63
20. Enriquez‒Sarano M, Basmadjian AJ, Rossi A, Bailey KR, Seward JB, Tajik AJ. Progression of mitral regurgitation: a prospective Doppler echocardiographic study. J Am Coll Cardiol 1999;34:1137– 44
21. Carpentier A. Cardiac valve surgery—the “French correction.” J Thorac Cardiovasc Surg 1983;86:323–37.
22. Schuler G, Peterson KL, Johnson A, et al. Temporal response of left ventricular performance to mitral valve surgery. Circulation 1979;59:1218–31.
23. Phillips HR, Levine FH, Carter JE, et al. Mitral valve replacement for isolated mitral regurgitation: analysis of clinical course and late postoperative left ventricular ejection fraction. Am J Cardiol 1981;48:647–54.
24. Crawford MH, Souchek J, Oprian CA, et al. Determinants of survival and left ventricular performance after mitral valve replacement: Department of Veterans Affairs Cooperative Study on Valvular Heart Disease. Circulation 1990;81:1173– 81.
25. Enriquez‒Sarano M, Tajik AJ, Schaff HV, Orszulak TA, Bailey KR, Frye RL. Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation 1994;90:830–7.
26. Enriquez‒Sarano M, Tajik AJ, Schaff HV, et al. Echocardiographic prediction of left ventricular function after correction of mitral regurgitation: results and clinical implications. J Am Coll Cardiol 1994;24:1536–43.
27. Zile MR, Gaasch WH, Carroll JD, Levine HJ. Chronic mitral regurgitation: predictive value of preoperative echocardiographic indexes of left ventricular function and wall stress. J Am Coll Cardio 1984;3:235– 42.
28. Wisenbaugh T, Skudicky D, Sareli P. Prediction of outcome after valve replacement for rheumatic mitral regurgitation in the era of chordal preservation. Circulation 1994;89:191–7.
29. Flemming MA, Oral H, Rothman ED, Briesmiester K, Petrusha JA, Starling MR. Echocardiographic markers for mitral valve surgery to preserve left ventricular performance in mitral regurgitation. Am Heart J 2000;140:476–82.
30. Yoran C, Yellin EL, Becker RM, Gabbay S, Frater RW, Sonnenblick EH. Mechanism of reduction of mitral regurgitation with vasodilator therapy. Am J Cardiol 1979;43:773–7.
31. Capomolla S, Febo O, Gnemmi M, et al. Beta‒blockade therapy in chronic heart failure: diastolic function and mitral regurgitation improvement by carvedilol. Am Heart J 2000;139:596–608.
32. Linde C, Leclercq C, Rex S, et al. Long‒term benefits of biventricular pacing in congestive heart failure: results from the MUltisite Stimulation in cardiomyopathy (MUSTIC) study. J Am Coll Cardiol 2002;40:111– 8.
33. Breithardt OA, Sinha AM, Schwammenthal E, et al. Acute effects of cardiac resynchronization therapy on functional mitral regurgitation in advanced systolic heart failure. J Am Coll Cardiol 2003;41:765–70.
34. St John Sutton MG, Plappert T, Abraham WT, et al. Effect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure. Circulation 2003;107:1985–90
35. Croft CH, Lipscomb K, Mathis K, et al. Limitations of qualitative angiographic grading in aortic or mitral regurgitation. Am J Cardiol 1984;53:1593– 8.
36. Society of Thoracic Surgeons National Cardiac Surgery Database. Available at:
http://www.sts.org/documents/pdf/Spring2005STSExecutiveSummary.pdf. November 2005HYPERLINK "http://www.sts.org/documents/pdf/Spring2005STSExecutiveSummary.pdf.%20November%2020 05" \h .
37. Bolling SF, Pagani FD, Deeb GM, Bach DS. Intermediate‒term outcome of mitral reconstruction in cardiomyopathy. J Thorac Cardiovasc Surg 1998;115:381– 6.
38. Chen FY, Adams DH, Aranki SF, et al. Mitral valve repair in cardiomyopathy. Circulation 1998;98:II124 –7.
39. Bishay ES, McCarthy PM, Cosgrove DM, et al. Mitral valve surgery in patients with severe left ventricular dysfunction. Eur J Cardiothorac Surg 2000;17:213–21.
40. Bolling SF. Mitral reconstruction in cardiomyopathy. J Heart Valve Dis 2002;11 Suppl 1:S26 – 31.
41. Badhwar V, Bolling SF. Mitral valve surgery in the patient with left ventricular dysfunction. Semin Thorac Cardiovasc Surg 2002;14: 133–6.
42. Wu AH, Aaronson KD, Bolling SF, Pagani FD, Welch K, Koelling TM. Impact of mitral valve annuloplasty on mortality risk in patients with mitral regurgitation and left ventricular systolic dysfunction. J Am Coll Cardiol 2005;45:381–7.
43. Enriquez‒Sarano M, Avierinos JF, Messika‒Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med 2005;352:875– 83.
44. Rosenhek R, Rader F, Klaas U. Outcome of watchful waiting in asymptomatic severe mitral regurgitation. Circulation 2006. In Press.
45. Grigioni F, Avierinos JF, Ling LH, et al. Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long‒term outcome. J Am Coll Cardiol 2002;40:84 –92.
46. Lim E, Barlow CW, Hosseinpour AR, et al. Influence of atrial fibrillation on outcome following mitral valve repair. Circulation 2001;104:I59–63.
47. Eguchi K, Ohtaki E, Matsumura T, et al. Pre‒operative atrial fibrillation as the key determinant of outcome of mitral valve repair for degenerative mitral regurgitation. Eur Heart J 2005;26:1866 –72.
48. Horskotte D, Schulte HD, Bircks W, Strauer BE. The effect of chordal preservation on late outcome after mitral valve replacement: a randomized study. J Heart Valve Dis 1993;2:150–8.
49. Chua YL, Schaff HV, Orszulak TA, Morris JJ. Outcome of mitral valve repair in patients with preoperative atrial fibrillation. Should the maze procedure be combined with mitral valvuloplasty? J Thorac Cardiovasc Surg 1994;107:408 –15.
50. Handa N, Schaff HV, Morris JJ, Anderson BJ, Kopecky SL, Enriquez‒Sarano M. Outcome of valve repair and the Cox maze procedure for mitral regurgitation and associated atrial fibrillation. J Thorac Cardiovasc Surg 1999;118:628 –35.
51. Schaff HV, Dearani JA, Daly RC, Orszulak TA, Danielson GK. Cox‒Maze procedure for atrial fibrillation: Mayo Clinic experience. Semin Thorac Cardiovasc Surg 2000;12:30 –7.
52. Cox JL. Intraoperative options for treating atrial fibrillation associated with mitral valve disease. J Thorac Cardiovasc Surg 2001;122: 212–5.
53. Raanani E, Albage A, David TE, Yau TM, Armstrong S. The efficacy of the Cox/maze procedure combined with mitral valve surgery: a matched control study. Eur J Cardiothorac Surg 2001;19: 438–42.
54. Kobayashi J, Sasako Y, Bando K, et al. Eight‒year experience of combined valve repair for mitral regurgitation and maze procedure. J Heart Valve Dis 2002;11:165–71.
55. Abreu Filho CAC, Lisboa LA, Dallan LA. Effectiveness of the maze procedure using cooledtip radiofrequency ablation in patients with permanent atrial fibrillation and rheumatic mitral valve disease. Circulation 2005;112:I20 –5.
56. Bando K, Kasegawa H, Okada Y, et al. Impact of preoperative and postoperative atrial fibrillation on outcome after mitral valvuloplasty for nonischemic mitral regurgitation. J Thorac Cardiovasc Surg 2005;129:1032– 40.
57. Edwards FH, Peterson ED, Coombs LP, et al. Prediction of operative mortality after valve replacement surgery. J Am Coll Cardiol 2001;37:885–92.
58. Goodney PP, O’Connor GT, Wennberg DE, Birkmeyer JD. Do hospitals with low mortality rates in coronary artery bypass also perform well in valve replacement? Ann Thorac Surg 2003;76:1131–6.
59. Lee EM, Porter JN, Shapiro LM, Wells FC. Mitral valve surgery in the elderly. J Heart Valve Dis 1997;6:22–31.
60. Sahar G, Abramov D, Erez E, et al. Outcome and risk factors in octogenarians undergoing open‒heart surgery. J Heart Valve Dis 1999;8:162–6.
61. Nowicki ER, Birkmeyer NJ, Weintraub RW, et al. Multivariable prediction of in‒hospital mortality associated with aortic and mitral valve surgery in Northern New England. Ann Thorac Surg 2004;77: 1966–77.
62. Nagendran J, Norris C, Maitland A, Koshal A, Ross DB. Is mitral valve surgery safe in octogenarians? Eur J Cardiothorac Surg 2005;28:83–7.
63. Connolly MW, Gelbfish JS, Jacobowitz IJ, et al. Surgical results for mitral regurgitation from coronary artery disease. J Thorac Cardiovasc Surg 1986;91:379–88.
64. Akins CW, Hilgenberg AD, Buckley MJ, et al. Mitral valve reconstruction versus replacement for degenerative or ischemic mitral regurgitation. Ann Thorac Surg 1994;58:668 –75.
65. Prifti E, Bonacchi M, Frati G, et al. Should mild‒to‒moderate and moderate ischemic mitral regurgitation be corrected in patients with impaired left ventricular function undergoing simultaneous coronary revascularization? J Card Surg 2001;16:473– 83.
66. Harris KM, Sundt TM, III, Aeppli D, Sharma R, Barzilai B. Can late survival of patients with moderate ischemic mitral regurgitation be impacted by intervention on the valve? Ann Thorac Surg 2002; 74:1468 –75.
67. Lam BK, Gillinov AM, Blackstone EH, et al. Importance of moderate ischemic mitral regurgitation. Ann Thorac Surg 2005;79:462–70.
68. Schroder JN, Williams ML, Hata JA, et al. Impact of mitral valve regurgitation evaluated by intraoperative transesophageal echocardiography on long‒term outcomes after coronary artery bypass grafting. Circulation 2005;112:I293– 8.
69. Levine RA, Schwammenthal E. Ischemic mitral regurgitation on the threshold of a solution: from paradoxes to unifying concepts. Circulation 2005;112:745–58.
70. Byrne JG, Aklog L, Adams DH. Assessment and management of functional or ischaemic mitral regurgitation. Lancet 2000;355:1743–4.
71. Grossi EA, Zakow PK, Sussman M, et al. Late results of mitral valve reconstruction in the elderly. Ann Thorac Surg 2000;70:1224–6.
72. Gangemi JJ, Tribble CG, Ross SD, McPherson JA, Kern JA, Kron IL. Does the additive risk of mitral valve repair in patients with ischemic cardiomyopathy prohibit surgical intervention? Ann Surg 2000;231:710–4.
73. Prifti E, Bonacchi M, Frati G, Giunti G, Babatasi G, Sani G. Ischemic mitral valve regurgitation grade II–III: correction in patients with impaired left ventricular function undergoing simultaneous coronary revascularization. J Heart Valve Dis 2001;10:754–62.
74. Gillinov AM, Wierup PN, Blackstone EH, et al. Is repair preferable to replacement for ischemic mitral regurgitation? J Thorac Cardiovasc Surg 2001;122:1125– 41.
75. Grossi EA, Goldberg JD, LaPietra A, et al. Ischemic mitral valve reconstruction and replacement: comparison of long‒term survival and complications. J Thorac Cardiovasc Surg 2001;122:1107–24.
76. Adams DH, Filsoufi F, Aklog L. Surgical treatment of the ischemic mitral valve. J Heart Valve Dis 2002;11 Suppl 1:S21–5.
77. Aklog L, Filsoufi F, Flores KQ, et al. Does coronary artery bypass grafting alone correct moderate ischemic mitral regurgitation? Circulation 2001;104:I68 –75.
78. Gillinov AM, Faber C, Houghtaling PL, et al. Repair versus replacement for degenerative mitral valve disease with coexisting ischemic heart disease. J Thorac Cardiovasc Surg 2003;125:1350–62.
79. Campwala SZ, Bansal RC, Wang N, Razzouk A, Pai RG. Factors affecting regression of mitral regurgitation following isolated coronary artery bypass surgery. Eur J Cardiothorac Surg 2005;28:104–8.
80. Hochman JS, Buller CE, Sleeper LA, et al. Cardiogenic shock complicating acute myocardial infarction– etiologies, management and outcome: a report from the SHOCK Trial Registry. SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK? J Am Coll Cardiol 2000;36:1063–70.
81. Tavakoli R, Weber A, Vogt P, Brunner HP, Pretre R, Turina M. Surgical management of acute mitral valve regurgitation due to post‒infarction papillary muscle rupture. J Heart Valve Dis 2002;11:20–5.
82. Carabello BA. Aortic regurgitation. A lesion with similarities to both aortic stenosis and mitral regurgitation 1. Circulation 1990;82:1051–3.
83. Gaasch WH, Andrias CW, Levine HJ. Chronic aortic regurgitation: the effect of aortic valve replacement on left ventricular volume, mass and function. Circulation 1978;58:825–36.
84. Schwarz F, Flameng W, Langebartels F, Sesto M, Walter P, Schlepper M. Impaired left ventricular function in chronic aortic valve disease: survival and function after replacement by Bjork‒Shiley prosthesis. Circulation 1979;60:48 –58.
85. Borer JS, Rosing DR, Kent KM, et al. Left ventricular function at rest and during exercise after aortic valve replacement in patients with aortic regurgitation. Am J Cardiol 1979;44:1297–305.
86. Bonow RO, Rosing DR, Maron BJ, et al. Reversal of left ventricular dysfunction after aortic valve replacement for chronic aortic regurgitation: influence of duration of preoperative left ventricular dysfunction. Circulation 1984;70:570 –9.
87. Carabello BA, Usher BW, Hendrix GH, Assey ME, Crawford FA, Leman RB. Predictors of outcome for aortic valve replacement in patients with aortic regurgitation and left ventricular dysfunction: a change in the measuring stick. J Am Coll Cardiol 1987;10:991–7.
88. Taniguchi K, Nakano S, Hirose H, et al. Preoperative left ventricular function: minimal requirement for successful late results of valve replacement for aortic regurgitation. J Am Coll Cardiol 1987;10:510–8.
89. Bonow RO, Dodd JT, Maron BJ, et al. Long‒term serial changes in left ventricular function and reversal of ventricular dilatation after valve replacement for chronic aortic regurgitation. Circulation 1988; 78:1108 –20.
90. Borer JS, Herrold EM, Hochreiter C, et al. Natural history of left ventricular performance at rest and during exercise after aortic valve replacement for aortic regurgitation. Circulation 1991;84:III133–9.
91. Hegglin R, Scheu H, Rothlin M. Aortic insufficiency. Circulation 1968;38:77–92.
92. Spagnuolo M, Kloth H, Taranta A, Doyle E, Pasternack B. Natural history of rheumatic aortic regurgitation. Criteria predictive of death, congestive heart failure, and angina in young patients. Circulation 1971;44:368–80.
93. Rapaport E. Natural history of aortic and mitral valve disease. Am J Cardiol 1975;35:221–7.
94. Ishii K, Hirota Y, Suwa M, Kita Y, Onaka H, Kawamura K. Natural history and left ventricular response in chronic aortic regurgitation. Am J Cardiol 1996;78:357– 61.
95. Aronow WS, Ahn C, Kronzon I, Nanna M. Prognosis of patients with heart failure and unoperated severe aortic valvular regurgitation and relation to ejection fraction. Am J Cardiol 1994;74:286–8.
96. Dujardin KS, Enriquez‒Sarano M, Schaff HV, Bailey KR, Seward JB, Tajik AJ. Mortality and morbidity of aortic regurgitation in clinical practice. A long‒term follow‒up study. Circulation 1999;99:1851–7.
97. Henry WL, Bonow RO, Rosing DR, Epstein SE. Observations on the optimum time for operative intervention for aortic regurgitation. II. Serial echocardiographic evaluation of asymptomatic patients. Circulation 1980;61:484 –92.
98. McDonald IG, Jelinek VM. Serial M‒mode echocardiography in severe chronic aortic regurgitation. Circulation 1980;62:1291– 6.
99. Bonow RO. Radionuclide angiography in the management of asymptomatic aortic regurgitation. Circulation 1991;84:I296 –302
100. Cheitlin MD, Armstrong WF, Aurigemma GP, et al. ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography—summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/ASE Committee to Update the 1997 Guidelines for the Clinical Application of Echocardiography). J Am Coll Cardiol 2003;42:954 –70.
101. Teague SM, Heinsimer JA, Anderson JL, et al. Quantification of aortic regurgitation utilizing continuous wave Doppler ultrasound. J Am Coll Cardiol 1986;8:592–9.
102. Labovitz AJ, Ferrara RP, Kern MJ, Bryg RJ, Mrosek DG, Williams GA. Quantitative evaluation of aortic insufficiency by continuous wave Doppler echocardiography. J Am Coll Cardiol 1986;8:1341–7.
103. Greenberg B, Massie B, Bristow JD, et al. Long‒term vasodilator therapy of chronic aortic insufficiency. A randomized double‒blinded, placebo‒controlled clinical trial. Circulation 1988;78:92–103.
104. Scognamiglio R, Fasoli G, Ponchia A, la‒Volta S. Long‒term nifedipine unloading therapy in asymptomatic patients with chronic severe aortic regurgitation. J Am Coll Cardiol 1990;16:424 –9.
105. Scognamiglio R, Rahimtoola SH, Fasoli G, Nistri S, Dalla VS. Nifedipine in asymptomatic patients with severe aortic regurgitation and normal left ventricular function. N Engl J Med 1994;331:689–94.
106. Evangelista A, Tornos P, Sambola A, Permanyer‒Miralda G, Soler‒Soler J. Long‒term vasodilator therapy in patients with severe aortic regurgitation. N Engl J Med 2005;353:1342– 9.
107. Cunha CL, Giuliani ER, Fuster V, Seward JB, Brandenburg RO, McGoon DC. Preoperative M‒mode echocardiography as a predictor of surgical results in chronic aortic insufficiency. J Thorac Cardiovasc Surg 1980;79:256–65.
108. Greves J, Rahimtoola SH, McAnulty JH, et al. Preoperative criteria predictive of late survival following valve replacement for severe aortic regurgitation. Am Heart J 1981;101:300–8.
109. Bonow RO, Picone AL, McIntosh CL, et al. Survival and functional results after valve replacement for aortic regurgitation from 1976 to 1983: impact of preoperative left ventricular function. Circulation 1985;72:1244 –56.
110. Clark DG, McAnulty JH, Rahimtoola SH. Valve replacement in aortic insufficiency with left ventricular dysfunction. Circulation 1980;61:411–21.
111. Bonow RO, Lakatos E, Maron BJ, Epstein SE. Serial long‒term assessment of the natural history of asymptomatic patients with chronic aortic regurgitation and normal left ventricular systolic function. Circulation 1991;84:1625–35..
112. Turina J, Turina M, Rothlin M, Krayenbuehl HP. Improved late survival in patients with chronic aortic regurgitation by earlier operation. Circulation 1984;70:I147–I152.
113. Klodas E, Enriquez‒Sarano M, Tajik AJ, Mullany CJ, Bailey KR, Seward JB. Aortic regurgitation complicated by extreme left ventricular dilation: long‒term outcome after surgical correction. J Am Coll Cardiol 1996;27:670 –7.
114. Elayda MA, Hall RJ, Reul RM, et al. Aortic valve replacement in patients 80 years and older. Operative risks and long‒term results. Circulation 1993;88:II11–16.
115. Olson LJ, Subramanian R, Edwards WD. Surgical pathology of pure aortic insufficiency: a study of 225 cases. Mayo Clin Proc 1984;59: 835–41.
116.Lindsay J Jr., Beall AC Jr., DeBakey ME. Diagnosis and treatment of diseases of the aorta. In: Schlant R, Alexander RW, editors. Hurst’s The Heart. New York, NY: McGraw Hill, 1998:2461– 82.
117. Ergin MA, Spielvogel D, Apaydin A, et al. Surgical treatment of the dilated ascending aorta: when and how? Ann Thorac Surg 1999;67:1834–9.
118. Cigarroa JE, Isselbacher EM, DeSanctis RW, Eagle KA. Diagnostic imaging in the evaluation of suspected aortic dissection. Old standards and new directions. N Engl J Med 1993;328:35– 43.
119. Nienaber CA, von KY, Nicolas V, et al. The diagnosis of thoracic aortic dissection by noninvasive imaging procedures. N Engl J Med 1993;328:1–9.
120. Smith MD, Cassidy JM, Souther S, et al. Transesophageal echocardiography in the diagnosis of traumatic rupture of the aorta. N Engl J Med 1995;332:356–62.
121. Rahimtoola SH. Recognition and management of acute aortic regurgitation. Heart Dis Stroke 1993;2:217–21.
122. Kern MJ, Serota H, Callicoat P, et al. Use of coronary arteriography in the preoperative management of patients undergoing urgent repair of the thoracic aorta. Am Heart J 1990;119:143– 8.
123. Israel DH, Sharma SK, Ambrose JA, Ergin MA, Griepp RR. Cardiac catheterization and selective coronary angiography in ascending aortic aneurysm or dissection. Cathet Cardiovasc Diagn 1994;32: 232–7.
124. Rizzo RJ, Aranki SF, Aklog L, et al. Rapid noninvasive diagnosis and surgical repair of acute ascending aortic dissection. Improved survival with less angiography. J Thorac Cardiovasc Surg 1994;108:567–74.

125. Penn MS, Smedira N, Lytle B, Brener SJ. Does coronary angiography before emergency aortic surgery affect in‒hospital mortality? J Am Coll Cardiol 2000;35:889 –94.

126. Boucher CA, Bingham JB, Osbakken MD, et al. Early changes in left ventricular size and function after correction of left ventricular volume overload. Am J Cardiol 1981;47:991– 1004..
127. Schuler G, Peterson KL, Johnson AD, et al. Serial noninvasive assessment of left ventricular hypertrophy and function after surgical correction of aortic regurgitation. Am J Cardiol 1979;44:585–94..
128. Carroll JD, Gaasch WH, Zile MR, Levine HJ. Serial changes in left ventricular function after correction of chronic aortic regurgitation. Dependence on early changes in preload and subsequent regression of hypertrophy. Am J Cardiol 1983;51:476–82.
129. Stephan PJ, Henry AC III, Hebeler RF Jr., Whiddon L, Roberts WC. Comparison of age, gender, number of aortic valve cusps, concomitant coronary artery bypass grafting, and magnitude of left ventricular‒systemic arterial peak systolic gradient in adults having aortic valve replacement for isolated aortic valve stenosis. Am J Cardiol 1997;79:166 –72.
130. Roberts WC, Ko JM. Frequency by decades of unicuspid, bicuspid, and tricuspid aortic valves in adults having isolated aortic valve replacement for aortic stenosis, with or without associated aortic regurgitation. Circulation 2005;111:920 –5.
131. Otto CM, Kuusisto J, Reichenbach DD, Gown AM, O’Brien KD. Characterization of the early lesion of ‘degenerative’ valvular aortic stenosis. Histological and immunohistochemical studies. Circulation 1994;90:844 –53.
132. Olsson M, Thyberg J, Nilsson J. Presence of oxidized low density lipoprotein in nonrheumatic stenotic aortic valves. Arterioscler Thromb Vasc Biol 1999;19:1218 –22.
133.Mohler ER, III, Gannon F, Reynolds C, Zimmerman R, Keane MG, Kaplan FS. Bone formation and inflammation in cardiac valves. Circulation 2001;103:1522– 8.
134. O’Brien KD, Shavelle DM, Caulfield MT, et al. Association of angiotensin‒converting enzyme with low‒density lipoprotein in aortic valvular lesions and in human plasma. Circulation 2002;106:2224–30.
135. Rajamannan NM, Subramaniam M, Rickard D, et al. Human aortic valve calcification is associated with an osteoblast phenotype. Circulation 2003;107:2181– 4.
136. Faggiano P, Aurigemma GP, Rusconi C, Gaasch WH. Progression of valvular aortic stenosis in adults: literature review and clinical implications. Am Heart J 1996;132:408 –17.
137. Otto CM, Pearlman AS, Gardner CL. Hemodynamic progression of aortic stenosis in adults assessed by Doppler echocardiography. J Am Coll Cardiol 1989;13:545–50.
138. Roger VL, Tajik AJ, Bailey KR, Oh JK, Taylor CL, Seward JB. Progression of aortic stenosis in adults: new appraisal using Doppler echocardiography. Am Heart J 1990;119:331– 8.
139. Davies SW, Gershlick AH, Balcon R. Progression of valvar aortic stenosis: a long‒term retrospective study. Eur Heart J 1991;12:10–4.
140. Faggiano P, Ghizzoni G, Sorgato A, et al. Rate of progression of valvular aortic stenosis in adults. Am J Cardiol 1992;70:229 –33.
141. Brener SJ, Duffy CI, Thomas JD, Stewart WJ. Progression of aortic stenosis in 394 patients: relation to changes in myocardial and mitral valve dysfunction. J Am Coll Cardiol 1995;25:305–10.
142. Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med 2000;343:611–7.
143. Cosmi JE, Kort S, Tunick PA, et al. The risk of the development of aortic stenosis in patients with “benign” aortic valve thickening. Arch Intern Med 2002;162:2345–7.
144. Stewart BF, Siscovick D, Lind BK, et al. Clinical factors associated with calcific aortic valve disease. Cardiovascular Health Study. J Am Coll Cardiol 1997;29:630–4.
145. Otto CM, Lind BK, Kitzman DW, Gersh BJ, Siscovick DS. Association of aortic‒valve sclerosis with cardiovascular mortality and morbidity in the elderly. N Engl J Med 1999;341:142–7.
146. Olsen MH, Wachtell K, Bella JN, et al. Aortic valve sclerosis relates to cardiovascular events in patients with hypertension (a LIFE substudy). Am J Cardiol 2005;95:132– 6.
147. Taylor HA Jr., Clark BL, Garrison RJ, et al. Relation of aortic valve sclerosis to risk of coronary heart disease in African‒Americans. Am J Cardiol 2005;95:401– 4.
148. Ross J Jr., Braunwald E. Aortic stenosis. Circulation 1968;38:61–7.
149. Rosenhek R, Klaar U, Schemper M, et al. Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J 2004;25:199 –205.
150. Otto CM, Burwash IG, Legget ME, et al. Prospective study of asymptomatic valvular aortic stenosis. Clinical, echocardiographic, and exercise predictors of outcome. Circulation 1997;95:2262–70.
151. Kelly TA, Rothbart RM, Cooper CM, Kaiser DL, Smucker ML, Gibson RS. Comparison of outcome of asymptomatic to symptomatic patients older than 20 years of age with valvular aortic stenosis. Am J Cardiol 1988;61:123–30.
152. Pellikka PA, Nishimura RA, Bailey KR, Tajik AJ. The natural history of adults with asymptomatic, hemodynamically significant aortic stenosis. J Am Coll Cardiol 1990;15:1012–
7.
153.Kennedy KD, Nishimura RA, Holmes DR Jr., Bailey KR. Natural history of moderate aortic stenosis. J Am Coll Cardiol 1991;17:313–9.
154. Pellikka PA, Sarano ME, Nishimura RA, et al. Outcome of 622 adults with asymptomatic, hemodynamically significant aortic stenosis during prolonged follow‒up. Circulation 2005;111:3290 –5.
155. Burwash IG, Hay KM, Chan KL. Hemodynamic stability of valve area, valve resistance, and stroke work loss in aortic stenosis: a comparative analysis. J Am Soc Echocardiogr 2002;15:814 –22.
156. Otto CM, Pearlman AS, Kraft CD, Miyake‒Hull CY, Burwash IG, Gardner CJ. Physiologic changes with maximal exercise in asymptomatic valvular aortic stenosis assessed by Doppler echocardiography. J Am Coll Cardiol 1992;20:1160 –7.
157. Bache RJ, Wang Y, Jorgensen CR. Hemodynamic effects of exercise in isolated valvular aortic stenosis. Circulation 1971;44:1003–13.
158. deFilippi CR, Willett DL, Brickner ME, et al. 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: 191–4.
159. Bermejo J, Garcia‒Fernandez MA, Torrecilla EG, et al. Effects of dobutamine on Doppler echocardiographic indexes of aortic stenosis. J Am Coll Cardiol 1996;28:1206 –13.
160. Lin SS, Roger VL, Pascoe R, Seward JB, Pellikka PA. Dobutamine stress Doppler hemodynamics in patients with aortic stenosis: feasibility, safety, and surgical correlations. Am Heart J 1998;136:1010–6.
161. 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 lowdose dobutamine echocardiography. J Am Coll Cardiol 2001;37:2101–7.
162. Schwammenthal E, Vered Z, Moshkowitz Y, et al. Dobutamine echocardiography in patients with aortic stenosis and left ventricular dysfunction: predicting outcome as a function of management strategy. Chest 2001;119:1766 –77.
163. Nishimura RA, Grantham JA, Connolly HM, Schaff HV, Higano ST, Holmes DR Jr. Lowoutput, low‒gradient aortic stenosis in patients with depressed left ventricular systolic function: the clinical utility of the dobutamine challenge in the catheterization laboratory. Circulation 2002;106:809 –13.
164. Monin JL, Quere JP, Monchi M, et al. Low‒gradient aortic stenosis: operative risk stratification and predictors for long‒term outcome: a multicenter study using dobutamine stress hemodynamics. Circulation 2003;108:319 –24.
165. Amato MC, Moffa PJ, Werner KE, Ramires JA. Treatment decision in asymptomatic aortic valve stenosis: role of exercise testing. Heart 2001;86:381– 6.
166. Das P, Rimington H, Chambers J. Exercise testing to stratify risk in aortic stenosis. Eur Heart J 2005;26:1309 –13.
167. Nylander E, Ekman I, Marklund T, Sinnerstad B, Karlsson E, Wranne B. Severe aortic stenosis in elderly patients. Br Heart J 1986;55:480 –7.
168. Atwood JE, Kawanishi S, Myers J, Froelicher VF. Exercise testing in patients with aortic stenosis. Chest 1988;93:1083–7.
169. Clyne CA, Arrighi JA, Maron BJ, Dilsizian V, Bonow RO, Cannon RO III. Systemic and left ventricular responses to exercise stress in asymptomatic patients with valvular aortic stenosis. Am J Cardiol 1991;68:1469 –76.
170.Alborino D, Hoffmann JL, Fournet PC, Bloch A. Value of exercise testing to evaluate the indication for surgery in asymptomatic patients with valvular aortic stenosis. J Heart Valve Dis 2002;11:204 –9.
171. Takeda S, Rimington H, Chambers J. Prediction of symptom‒onset in aortic stenosis: a comparison of pressure drop/flow slope and haemodynamic measures at rest. Int J Cardiol 2001;81:131–7.
172. Letac B, Cribier A, Koning R, Bellefleur JP. Results of percutaneous transluminal valvuloplasty in 218 adults with valvular aortic stenosis.Am J Cardiol 1988;62:598–605.
173. Block PC, Palacios IF. Clinical and hemodynamic follow‒up after percutaneous aortic valvuloplasty in the elderly. Am J Cardiol 1988;62:760 –3.
174. Brady ST, Davis CA, Kussmaul WG, Laskey WK, Hirshfeld JW Jr., Herrmann HC. Percutaneous aortic balloon valvuloplasty in octogenarians:morbidity and mortality. Ann Intern Med 1989;110:761– 6.
175. Fields CD, Rosenfield K, Lasordo DW, Isner JM. Percutaneous balloon valvuloplasty: current status. Curr Opinion Cardiol 1989;4:229–42.
176. Berland J, Cribier A, Savin T, Lefebvre E, Koning R, Letac B.Percutaneous balloon valvuloplasty in patients with severe aortic stenosis and low ejection fraction. Immediate results and 1‒year follow‒up. Circulation 1989;79:1189 –96.
177. Davidson CJ, Harrison JK, Leithe ME, Kisslo KB, Bashore TM. Failure of balloon aortic valvuloplasty to result in sustained clinical improvement in patients with depressed left ventricular function. Am J Cardiol 1990;65:72–7.
178. Otto CM, Mickel MC, Kennedy JW, et al. Three‒year outcome after balloon aortic valvuloplasty. Insights into prognosis of valvular aortic stenosis. Circulation 1994;89:642–50.
179. Lieberman EB, Bashore TM, Hermiller JB, et al. Balloon aortic valvuloplasty in adults: failure of procedure to improve long‒term survival. J Am Coll Cardiol 1995;26:1522– 8.
180. Block PC. Aortic valvuloplasty—a valid alternative? N Engl J Med 1988;319:169 –71.
181. Nishimura RA, Holmes DR Jr., Reeder GS. Percutaneous balloon valvuloplasty. Mayo Clin Proc 1990;65:198 –220.
182. Rahimtoola SH. Catheter balloon valvuloplasty for severe calcific aortic stenosis: a limited role. J Am Coll Cardiol 1994;23:1076–8.
183. O’Keefe JH Jr., Shub C, Rettke SR. Risk of noncardiac surgical procedures in patients with aortic stenosis. Mayo Clin Proc 1989;64:400–5.
184. Torsher LC, Shub C, Rettke SR, Brown DL. Risk of patients with severe aortic stenosis undergoing noncardiac surgery. Am J Cardiol 1998;81:448 –52.
185. Raymer K, Yang H. Patients with aortic stenosis: cardiac complications in non‒cardiac surgery. Can J Anaesth 1998;45:855–9.
186. Brighouse D. Anaesthesia for caesarean section in patients with aortic stenosis: the case for regional anaesthesia. Anaesthesia 1998;53:107–9.
187. Christ M, Sharkova Y, Geldner G, Maisch B. Preoperative and perioperative care for patients with suspected or established aortic stenosis facing noncardiac surgery. Chest 2005;128:2944 –53.
188. Moreira FC, Manfroi WC, Werutsky G, Bittencourt JA. Management of mild aortic stenosis in patients undergoing coronary bypass surgery. Arq Bras Cardiol 2001;77:494 –9.
189. Filsoufi F, Aklog L, Adams DH, Byrne JG. Management of mild to moderate aortic stenosis at the time of coronary artery bypass grafting. J Heart Valve Dis 2002;11 Suppl 1:S45–9.
190.Smith WT, Ferguson TB Jr., Ryan T, Landolfo CK, Peterson ED. Should coronary artery bypass graft surgery patients with mild or moderate aortic stenosis undergo concomitant aortic valve replacement? A decision analysis approach to the surgical dilemma. J Am Coll Cardiol 2004;44:1241–7.
191. Pereira JJ, Balaban K, Lauer MS, Lytle B, Thomas JD, Garcia MJ. Aortic valve replacement in patients with mild or moderate aortic stenosis and coronary bypass surgery. Am J Med 2005;118:735– 42.
192. Gillinov AM, Garcia MJ. When is concomitant aortic valve replacement indicated in patients with mild to moderate stenosis undergoing coronary revascularization? Curr Cardiol Rep 2005;7:101– 4.
193. Eslami M, Rahimtoola SH. Prophylactic aortic valve replacement in older patients for mild aortic stenosis during coronary bypass surgery. Am J Geriatr Cardiol 2003;12:197–200.
194. Karagounis A, Valencia O, Chandrasekaran V, Smith J, Brecker S, Jahangiri M. Management of patients undergoing coronary artery bypass graft surgery with mild to moderate aortic stenosis. J Heart Valve Dis 2004;13:369 –73.
195. Tsai TP, Denton TA, Chaux A, et al. Results of coronary artery bypass grafting and/or aortic or mitral valve operation in patients or 90 years of age. Am J Cardiol 1994;74:960 –2.
196. Sprigings DC, Forfar JC. How should we manage symptomatic aortic stenosis in the patient who is 80 or older? Br Heart J 1995;74:481– 4.
197. Khot UN, Novaro GM, Popovic ZB, et al. Nitroprusside in critically ill patients with left ventricular dysfunction and aortic stenosis. N Engl J Med 2003;348:1756–63.

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