title: Differences in recovery of left and right ventricular function following aortic valve interventions: a longitudinal echocardiographic study in patients undergoing surgical, transapical or transfemoral aortic valve implantation.
abstract: OBJECTIVE
  To evaluate longitudinal left and right ventricular function (LVF and RVF) after transcatheter aortic valve implantation (TAVI) as compared to surgical aortic valve replacement (SAVR) and LVF and RVF after TAVI by the transfemoral (TF) or transapical (TA) approach.
  
  
  BACKGROUND
  Knowledge about differences in recovery of LVF and RVF after TAVI and SAVR is scarce.
  
  
  METHODS
  Sixty patients (age 81 ± 7 years, logistic EuroSCORE 16 ± 10%), undergoing TAVI (TF: n = 35 and TA: n = 25), were examined by echocardiography including atrioventricular plane displacement (AVPD) and peak systolic velocities (PSV) by tissue Doppler at basal RV free wall, LV lateral wall and septum preprocedurally, 7 weeks and 6 months postprocedurally. Twenty-seven SAVR patients were matched to 27 TAVI patients by age, gender and LVF.
  
  
  RESULTS
  Early postintervention, TAVI patients had improved longitudinal LVF. However, when analyzed separately, only TF, but not TA patients, had improved LV lateral and septal AVPD and PSV (all P ≤ 0.01). All TAVI patients, as well as the TF and TA group had unchanged longitudinal LVF between the early and late follow-ups (all P > 0.05). The SAVR group had higher septal LVF than the matched TAVI group preprocedurally, while postoperatively this difference was diminished. Longitudinal RVF was better in the TF group than in the TA group pre- and postprocedurally. Although the SAVR group had superior longitudinal RVF preoperatively, this was inferior to TAVI postoperatively.
  
  
  CONCLUSIONS
  Postprocedural longitudinal LVF and RVF in patients undergoing TF-TAVI, TA-TAVI, or SAVR differ considerably. Preservation of longitudinal RVF after TAVI might influence the selection of aortic valve intervention in the future.
authors.affiliation: Division of Clinical Physiology, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Forsberg
authors.forename: Éva
authors.initials: É
authors.lastname: Tamás
authors.forename: Farkas
authors.initials: F
authors.lastname: Vánky
authors.forename: Jan
authors.initials: J
authors.lastname: Engvall
authors.forename: Eva
authors.initials: E
authors.lastname: Nylander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006328:Cardiac Catheterization / Q000379:methods*; D015150:Echocardiography, Doppler; D005263:Femoral Artery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right
keywords: aortic stenosis; echocardiography; thoracic surgery; transcatheter aortic valve implantation