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Ann Thorac Surg 2000;69:531-535
© 2000 The Society of Thoracic Surgeons

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Original Articles

Regression of hypertrophy after Carpentier-Edwards pericardial aortic valve replacement

^a Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California, USA
^b Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA

Address reprint requests to Dr Khan, Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Room 6215, Los Angeles, CA 90048
e-mail: khan{at}csmc.edu

Background. The purpose of this study was to determine whether significant regression of left ventricular hypertrophy is seen after implantation of small sizes (19 to 23 mm) of the Carpentier-Edwards (CE) pericardial valve, a stented pericardial valve.

Methods. Echocardiograms and electrocardiograms (ECGs) were performed at least 1 year after surgery (mean 18 months) in patients with 19-, 21-, and 23-mm CE pericardial aortic valves and compared with preoperative echocardiograms and ECGs.

Results. A total of 41 patients, mean age 79 ± 9 years (range 46 to 93 years), were studied, including 7 19-mm, 22 21-mm, and 12 23-mm patients. The mean postoperative gradient was 22 ± 7 mm Hg for 19-mm valves, 18 ± 5 mm Hg for 21-mm valves, and 16 ± 4 mm Hg for 23-mm valves. The postoperative valve areas were 1.1 ± 0.3 cm² for the 19-mm, 1.3 ± 0.3 cm² for the 21-mm, and 1.5 ± 0.4 cm² for the 23-mm valves. Left ventricular end diastolic diameter, end systolic diameter, septal thickness, and posterior wall thickness all decreased significantly (p <0.05) postoperatively. The proportion of patients with significant left ventricular hypertrophy on ECG decreased from 63% to 47% (p = 0.001). Left ventricular mass decreased significantly by echocardiography from 265 g preoperatively to 208 g postoperatively (p = 0.004). Left ventricular mass decreased for each valve size, and the greatest absolute reduction in mass occurred in the 19-mm valve recipients.

Conclusions. Implantation of the 19-, 21-, and 23-mm CE pericardial valves results in significant reductions in left ventricular mass. These findings suggest that stented pericardial valves can be used in the small aortic root without the need for aortic root enlargement procedures.

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