Left ventricular muscle mass regression after aortic valve replacement.
10.3346/jkms.1999.14.5.511
- Author:
Jae Won LEE
1
;
Kang Ju CHOI
;
Sang Gwon LEE
;
Suk Jung CHOO
;
Jong Ook KIM
;
Duk Hyun KANG
;
Jae Kwan SONG
;
Meong Gun SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan, Seoul, Korea. jwlee@www.amc.seoul.kr
- Publication Type:Original Article ; Clinical Trial
- Keywords:
Aortic valve;
Hemodynamics;
Heart hypertrophy;
Ventricular function, left;
Prosthesis failure
- MeSH:
Adult;
Aged;
Aortic Valve/ultrasonography;
Aortic Valve Stenosis/surgery*;
Aortic Valve Stenosis/complications;
Echocardiography;
Electrocardiography;
Female;
Follow-Up Studies;
Heart Valve Prosthesis*;
Human;
Hypertrophy, Left Ventricular/prevention & control*;
Hypertrophy, Left Ventricular/etiology;
Hypertrophy, Left Ventricular/diagnosis;
Male;
Middle Age;
Multivariate Analysis;
Postoperative Period;
Remission Induction;
Risk Factors;
Treatment Outcome
- From:Journal of Korean Medical Science
1999;14(5):511-519
- CountryRepublic of Korea
- Language:English
-
Abstract:
Implanting a valve that will reduce left ventricular mass is critical in aortic stenosis. Regression of left ventricular hypertrophy in 46 aortic valve replacement (AVR) patients receiving a St. Jude Medical (SJM) valve was assessed by serial electrocardiographic and echocardiographic studies during the preoperative, immediate, and late postoperative periods. The patients were divided into three groups according to valve size; 19 mm group (n=9), 21 mm group (n=20), and 23+mm group (n=17). There was no surgical mortality. The NYHA functional class improved from an average of 2.2+/-0.8 preoperatively to 1.3+/-0.5 post-operatively. Left ventricular muscle mass index (LVMI) regression failed to reach statistical significance in the 19 mm group, whereas in the other two groups a steady decrease in the LVMI occurred with follow up. ECG findings were less remarkable showing insignificant differences in voltage among the three groups (p=0.000). In conclusion, the current data suggest that the 19 mm SJM valve may not result in satisfactory left ventricular muscle mass regression despite adequate function, even in small patients. Therefore, additional procedures to accommodate a larger valve may be warranted in the aortic annulus smaller than 21 mm.
