Early left ventricular remodeling after aortic valve replacement.
BACKGROUND
Aortic valve disease is associated with eccentric or concentric left ventricular (LV) hypertrophy and changes in the LV mass. The relationship between LV mass and function and the effect of LV remodeling after aortic valve replacement (AVR), in patients with aortic valve disease needs evaluation, that is largely unknown in our population. The aim of this study was to evaluate the effect of AVR on LV remodeling, in patients with aortic valve disease.


METHODS
Fifty patients with aortic valve disease were studied using transthoracic echocardiography to assess LV mass before AVR and compared with early postoperative changes in the LV dimensions and function. LV mass was studied preoperatively and before discharge in 50 consecutive patients undergoing isolated aortic valve replacement.


RESULTS
Out of fifty patients, 47 (94%) were male and 03 (6%) were female. Mean age of the patients was 40.42 years. 22 (44%) had isolated aortic stenosis (AS), 16 (32%) patients had isolated aortic regurgitation (AR) and 12 (24%) patients had mixed aortic valve disease (MAVD). 02 (4%) patients died. LV mass regression was studied in all the patients. In group A, with aortic stenosis, LV regressed to 69.88 gm (mean) with maximum of 156.88 gms and minimum of 0.00 gms (SD 43.67 gms, p value = 0.001). In group B, with aortic regurgitation, LV mass regressed to 203.96 gms (mean) with maximum 453.79 gms and minimum of 45.65 gms (SD 95.33, p value = < 0.001). In group C, with mixed aortic valve disease, postoperatively LV mass regressed to 122.94 gms (mean) with minimum 9.57 and maximum of 224.75 gms (SD 69.53, p value = 0.524).


CONCLUSIONS
There was significant early LV mass regression after aortic valve replacement in patients with pre existing aortic valve disease. However, it was noticed that LV mass regressed in all patients except no significant changes in LV wall thickness (hypertrophy).
Ahmad
Naseem
N
Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore, Pakistan.
Shahbaz
Ahmad
A
Ghaffar
Abdul
A
Tufail
Zafar
Z
Waheed
Abdul
A
Khan
Jawad Sajid
JS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013997:Time Factors; D014463:Ultrasonography; D020257:Ventricular Remodeling