Mass regression in aortic stenosis after valve replacement with small size pericardial bioprosthesis.
BACKGROUND
The aim of the study was to determine whether left ventricular mass regression is influenced by valve size after the implantation of a Carpentier-Edwards Perimount (CEP) pericardial bioprosthesis for pure aortic stenosis.


METHODS
Patients receiving 19-mm, 21-mm, and 23-mm CEP aortic valves underwent echocardiography preoperatively and at least 1 year after surgery (mean, 2.3 +/- 1 years) and the echocardiograms were compared within and between groups.


RESULTS
The study involved a total of 88 patients: 34 receiving 19-mm CEPs, 29 receiving 21-mm CEPs, and 25 receiving 23-mm CEPs. The mean postoperative prosthetic gradients were respectively 20.6 +/- 6.6 mm Hg, 17.9 +/- 5.8 mm Hg, and 13.2 +/- 4.1 mm Hg (p = 0.0001); the mean postoperative valve areas were respectively 1.24 +/- 0.16 cm(2), 1.45 +/- 0.2 cm(2), and 1.63 +/- 0.21 cm(2) (p = 0.0001). In comparison with the preoperative echocardiographic measurements absolute left ventricular mass significantly decreased by -54.1 +/- 48.8 g, -54.1 +/- 55.1 g, and -74.4 +/- 57.4 g respectively with no statistically significant between-group difference (analysis of variance) but ventricular septum and posterior wall thickness significantly decreased in each group (p < 0.05).


CONCLUSIONS
The implantation of 19-mm, 21-mm, and 23-mm CEP aortic prostheses significantly reduces left ventricular mass without any size-related differences.
Tasca
Giordano
G
Department of Cardiac Surgery, Hospital Poliambulanza, Brescia, Italy. cch-segreteria.poli@poliambulanza.it
Brunelli
Federico
F
Cirillo
Marco
M
Amaducci
Andrea
A
Mhagna
Zen
Z
Troise
Giovanni
G
Quaini
Eugenio
E
D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000473:pathology; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D011474:Prosthesis Design