[Aortic valve replacement in patients with heart failure].
Severe aortic regurgitation and stenosis are urgent indication for aortic valve replacement in patients with left ventricular dysfunction, however the effect of cardiac surgery may differ in both groups. The aim of the study was to evaluate the early changes of haemodynamic parameters of heart: ejection fraction, endsystolic and enddiastolic left ventricle diameters, endsystolic and enddiastolic left ventricular wall thickness and left atrium diameter, depending on ejection fraction value (EF), in patients undergoing aortic valve replacement due to isolated aortic stenosis or regurgitation.


METHODS
250 patients engaged to the study were subjected to the mechanical aortic valve replacement in Cardiac Surgery Department in Lodz. All patients were divided into two groups--patients operated due to aortic regurgitation and aortic stenosis. Then each group, depending on EF volume before operation, was divided into two subgroups (A - EF between 35 and 50%; B - EF below 35%).


RESULTS
Comparing the pre- and early postoperative period, ejection fraction rose markedly in both subgroups of patients with aortic stenosis and the highest increase was ascertained in subgroups A. Analyzing endsystolic and enddiastolic left ventricle diameters we observed the reduction of left ventricle diameters in all groups. Evaluating endsystolic left ventricular wall thickness we observed the increase of wall thickness in both subgroups B. Analogically enddiastolic left ventricular wall thickness increased in all analyzing groups, whereas in groups with lowest fraction the rise was essential.


CONCLUSIONS
Aortic valve replacement both due to aortic stenosis and regurgitation is associated with improved haemodynamic status in early postoperative period.
Banach
Maciej
M
Uniwersytet Medyczny w Lodzi, Szpital Kliniczny Nr 3, Klinika Kardiochirurgii I Katedry Kardiologii i Kardiochirurgii. maciej.banach@kardiolog.pl
Okoński
Piotr
P
Kośmider
Anna
A
Irzmański
Robert
R
Rysz
Jacek
J
Olszewski
Robert
R
Zwoliński
Radosław
R
Zasłonka
Janusz
J
D001024:Aortic Valve Stenosis / Q000150:complications* / Q000601:surgery*; D005260:Female; D006333:Heart Failure / Q000209:etiology* / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged