Regression of Left Ventricular Hypertrophy after AVR in Aortic Valvular Stenosis

Lee, Jae won; Chui, Kang Joo; Song, Myung Keun

Abstract

BACKGROUND: The regression of the left ventricular hypertrophy after prosthetic valve replacement in patients with aortic valvular stenosis is an important factor to determine the appropriateness of the replaced prosthetic valvular size. Methods: To assess the regression of myocardial hypertrophy, a retrospective analysis of Doppler echocardiographic and electrocardiographic data was undertaken before, soon after (7.5+/-2.1 day), and late after (10.7+/-1.8 months) surgery in 36 patients (22 males, 14 female, mean age 54+/-12.1 years, mean BSA 1.61+/-0.15m2) with predominant aortic valvular stenosis. The patients underwent St. Jude Medical aortic valve replacement. By the size of the valves used, the patients were divided into three groups (19, 21 and 23+). RESULTS: The mean body surface area (1.48+/-0.13) in the patients with the 19 mm valve was smaller than that in the other groups (1.63+/-0.12) (p<0.05). No significant changes of ejection fraction were detected in all groups over time. Left ventricular muscle mass index (gm/m2) was reduced significantly in the 21 and 23+ groups over time (p<0.05), but there were no significant changes in the 19 mm valve group. The electric voltage height on EKG at the period of late after surgery was reduced significantly in all groups (p<0.05).
CONCLUSION
Despite clinical improvement, the LVH was not reduced significantly in 19 mm valve group. Thus we suggest that more attention and additional procedures such as annular enlargement should be taken in patients who will undergo the replacement of 19 mm prosthetic valve.