VALVULAR REPLACEMENT FOR AORTIC-STENOSIS ON PATIENTS IN NYHA CLASS-III AND CLASS-IV - EARLY AND LONG-TERM RESULTS

From January 1972 to June 1990, 112 patients between 39 and 83 years o ld, divided into 68 NYHA class III (60.72%) and 44 NYHA class IV, unde rwent surgery for aortic stenosis. There were 67 male (59.82%) and 45 female (40.18%). Early mortality included 8 patients (7.14%). Actuaria l survival (including early postoperative mortality) for all 112 patie nts was 88.39%, 77.67%, 67.85% and 65.7% t one year, five, ten and fif teen years respectively, Clinical criteria are subjective but they rem ain the best prognostic factor, Surgery is indicated at occurrence of first symptoms, but, even in advanced cases, aortic valvular replaceme nt can significantly improve survival and functional status. Even if o perative risk is increased and secondary cardiomyopathy often progress es after surgery, aortic valve replacement results seem better than th ose of medical treatment alone.