J Korean Med Sci.  1999 Oct;14(5):511-519. 10.3346/jkms.1999.14.5.511.

Left ventricular muscle mass regression after aortic valve replacement

• Lee JW
• Choi KJ
• Lee SG
• Choo SJ
• Kim JO
• Kang DH
• Song JK
• Song MG

• KMID: 646018
• DOI: http://doi.org/10.3346/jkms.1999.14.5.511

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.

Keyword

Aortic valve; Hemodynamics; Heart hypertrophy; Ventricular function, left; Prosthesis failure

MeSH Terms

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