title: Ventricular energetics in aortic root replacement for annuloaortic ectasia with aortic regurgitation.
abstract: Aortic root replacement (Bentall operation) is the standard operation for patients who have lesions of the ascending aorta associated with aortic valve disease. We analyzed the mid-term results for left ventricular energetics after the Bentall operation for annuloaortic ectasia with aortic regurgitation. We measured left ventricular contractility (end-systolic elastance; Ees), afterload (effective arterial elastance; Ea), and efficiency (ventriculoarterial coupling; Ea/Ees, and the ratio of stroke work and pressure-volume area; SW/PVA) based on transthoracic echocardiography data before, after, and approximately 1 year after the Bentall operation in 15 patients with annuloaortic ectasia with aortic regurgitation. Left ventricular volume was calculated by the Teichholz M-mode method. Ees and Ea were approximated as follows: Ees=mean blood pressure/minimal left ventricular volume, and Ea=systolic blood pressure/(maximal left ventricular volume--minimal left ventricular volume). Ea/Ees and SW/PVA were then calculated. Left ventricular volume was normalized with body surface area. Ees increased after the Bentall operation and around 1 year later (from 2.17+/-1.09 to 3.92+/-2.26 and 5.33+/-1.90 mmHg x m(2)/ml, P<0.001), thus resulting in an improvement in SW/PVA (from 68.8+/-8.2 to 70.9+/-9.5 and 74.7+/-5.2%, P=0.045). Ea also increased after the Bentall operation and 1 year later (from 1.77+/-0.61 to 2.88+/-1.28 and 3.54+/-1.43 mmHg x m(2)/ml, P<0.001). The mid-term results for ventricular contractility and efficiency after the Bentall operation for annuloaortic ectasia with aortic regurgitation are excellent and satisfactory.
authors.affiliation: Department of Cardiovascular Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. tanoue@heart.med.kyushu-u.ac.jp
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Tanoue
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Tomita
authors.forename: Shigeki
authors.initials: S
authors.lastname: Morita
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tominaga
mesh_terms: D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000503:physiopathology* / Q000601:surgery; D002306:Cardiac Volume / Q000502:physiology*; D004108:Dilatation, Pathologic; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D016276:Ventricular Function / Q000502:physiology*; D055815:Young Adult