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Ann Thorac Surg 1988;46:79-84
© 1988 The Society of Thoracic Surgeons

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Articles

Coronary Flow Characteristics of Left Coronary Artery in Aortic Regurgitation before and after Aortic Valve Replacement

Departments of Thoracic Surgery and Medical Engineering, Kawasaki Medical School, Kurashiki, Japan

Accepted for publication January 25, 1988.

^* Address reprint requests to Dr. Fujiwara, Department of Thoracic Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, Japan

In 6 patients with pure aortic regurgitation, the velocity waveform in the left anterior descending coronary artery (LAD) was measured using an 80-channel 20-MHz-pulse Doppler velocimeter before and immediately after aortic valve replacement. All patients showed normal coronary angiograms. Flow velocity was analyzed by both zero-cross and fast Fourier transform methods in real time. The LAD flow in severe aortic regurgitation was characterized by an increase in the systolic flow component, a small and rapidly decreased diastolic flow, an irregular velocity profile across the vessel, and a wider velocity spectrum. After aortic valve replacement, systolic flow decreased by 36.3 ± 21.7% (p < 0.01), whereas diastolic flow increased by 81.4 ± 51.8% (p < 0.05). The ratio of diastolic flow to total LAD flow increased from 63 ± 13% to 82 ± 7% (p < 0.05). The velocity profile became more parabolic and had a narrow spectrum. These results suggest that operation for aortic regurgitation induces beneficial effects on the myocardial inflow immediately after valve replacement.

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