[Late postoperative left ventricular function and ventricular hypertrophy after prosthetic valve replacement for aortic regurgitation].
Forty-two of 50 patients, who had undergone aortic valve replacement for acquired aortic regurgitation from Jan 1979 to Dec 1985, received late postoperative cardiac catheterization two years after operation. Their ages ranged between 10 and 69 years old (mean +/- S.D., 45.8 +/- 12.2 y.o.) and 37 men and 13 women were included. Postoperative left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV) and left ventricular mass (LVM) decreased significantly compared to preoperative levels, respectively (p less than 0.001). Both postoperative left ventricular end-systolic stress/end-systolic volume ratio (LVESS/ESVI) and tension volume ejection fraction (TVEF) increased significantly (p less than 0.01) compared to preoperative levels. Positive correlations were recognized between preoperative and postoperative values in LVESV, LVM, LVESS/ESVI, TVEF and LVEF. In the patients who had showed preoperative values of LVEDVI less than 180 ml/m2, LVESVI less than 90 ml/m2 and LVEF more than 0.52, their postoperative values were expected to be normal. There were also negative correlations between LVESVI and LVEF, and between LVM and contractile properties. Nineteen patients, who had recovered normal ventricular volumes at the time of postoperative cardiac catheterization, showed normal LV dimensions and % fractional shortening between five and ten years after operation. These results demonstrate the limitation of recovery in LVM and contractile properties in spite of normalization in ventricular volume and ejection performance.
Hayashi
J
J
Second Department of Surgery, Niigata University School of Medicine, Japan.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D006332:Cardiomegaly / Q000209:etiology / Q000503:physiopathology*; D002648:Child; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D011184:Postoperative Period; D013318:Stroke Volume; D016277:Ventricular Function, Left