Korean Circ J.  1984 Jun;14(1):37-44. 10.4070/kcj.1984.14.1.37.

Preoperative and Long-Term Postoperative Echocardiographic Evaluation of Chronic Aortic Insufficiency; Optimal Timing for Aortic Valve Replacement

• Han DS
• Park SW
• Kim JH
• Choi YS
• Seo J
• Lee YW
• Lee YK

• KMID: 2229811
• DOI: http://doi.org/10.4070/kcj.1984.14.1.37

Abstract

To dtermine the optimal timing for Aortic Valve Replacement in patients of aortic insufficiency is very important, because irreversible myocardial damage can result before symtoms such as dyspnea, syncope and chest pain, appear for the first time. Henry suggested that the echocardiographic index of left ventricular end systolic dimension 55mm could be useful as an indicator of whether to operate or not. But Fioretti, et al., insisted that there was no significant difference postoperatively between those below 55mm and those over 55mm. To determine whether a left ventricular end systolic dimension greater than 55mm is one of the risk factors for AVR in patients with aortic insufficiency, we analyzed the serial echocardiographic examinations of 23 patients who underwent AVR for isolated AI. Group I patients (n=17) had a preoperative left ventricular end systolic dimension less than or equal to 55mm and Group II patients (n=6) had a preoperative left ventricular end systolic dimension greater than than 55mm. 1) left ventricular end systolic dimension decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 modths after operation. 2) Left ventricular end diastolic dimension also decreased in both groups significantly, and there was a statistically significant difference between Group I and Group II at 12 months after operation. 3) Ejection Fraction was decreased markedly just postoperatively, but it was recovered soon in both groups, and there was no statistically significant differences of the ejection fractions between the two groups postoperatively. 4) SV1+/-RV6 in EKG, as an indicator of LV mass, was also analzed and it revealed significant reduction in both groups postoperatively, but we could not observe statistically significant differences between the two groups from 6 months after the operation. We concluded that the preoperative left ventricular end systolic dimension 55mm could be useful as an index to predict postoperative prognosis and to determine the timing of aortic valve replacement.

MeSH Terms

Aortic Valve*
Chest Pain
Dyspnea
Echocardiography*
Electrocardiography
Humans
Prognosis
Risk Factors
Syncope