HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Giordano Tasca Federico Brunelli Marco Cirillo Margherita Dalla Tomba Zen Mhagna Giovanni Troise Eugenio Quaini Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Tasca, G. Articles by Quaini, E. Search for Related Content PubMed PubMed Citation Articles by Tasca, G. Articles by Quaini, E. Related Collections Valve disease

Ann Thorac Surg 2005;79:1291-1296
© 2005 The Society of Thoracic Surgeons

---

Original articles: Cardiovascular

Impact of the Improvement of Valve Area Achieved With Aortic Valve Replacement on the Regression of Left Ventricular Hypertrophy in Patients With Pure Aortic Stenosis

Department of Cardiac Surgery, Poliambulanza Hospital, Brescia, Italy

Accepted for publication September 2, 2004.

^_* Address reprint requests to Dr Tasca, UF di Cardiochirurgia, Poliambulanza Hospital, Via L. Bissolati 57, 25125 Brescia, Italy (E-mail: cch-segreteria.poli{at}poliambulanza.it).

BACKGROUND: Previous studies have reported that patient-prosthesis mismatch may be associated with lesser regression of left ventricular hypertrophy. However, among the patients with mismatch, the extent of left ventricular mass regression varied markedly from one patient to another, and we hypothesized that it could be related to the magnitude of the increase in valve area achieved with aortic valve replacement. Our aim was to examine the relationship between the improvement in valve effective orifice area obtained with aortic valve replacement and the extent of postoperative left ventricular mass regression in patients with patient-prosthesis mismatch.

METHODS: Preoperative and postoperative measurements of valve effective orifice area, transvalvular pressure gradient, and left ventricular mass were obtained by Doppler echocardiography in 111 patients with pure aortic stenosis who were found to have patient-prosthesis mismatch based on an indexed effective orifice area of 0.8 cm²/m² or less after operation.

RESULTS: On average, the valve effective orifice area increased by 0.45 ± 0.24 cm²/m² with operation, and mean transvalvular pressure gradients decreased by –31.6 ± 13.5 mm Hg. The absolute and relative differences between preoperative and postoperative left ventricular mass were –28 ± 30 g and –17% ± 18%, respectively. In multivariate analysis, higher preoperative left ventricular mass (p < 0.0001) and larger increase in indexed valve effective orifice area with operation (p = 0.019) were independently associated with greater left ventricular mass regression.

CONCLUSIONS: This study shows that in patients with patient-prosthesis mismatch, the degree of left ventricular mass regression is influenced by the increase in valve effective orifice area achieved by aortic valve replacement.

This article has been cited by other articles:

				E. Balaras, K.S. Cha, B. P. Griffith, and J. S. Gammie Treatment of aortic stenosis with aortic valve bypass (apicoaortic conduit) surgery: an assessment using computational modeling. J. Thorac. Cardiovasc. Surg., March 1, 2009; 137(3): 680 - 687. [Abstract] [Full Text] [PDF]

				J. S. Gammie, L. S. Krowsoski, J. M. Brown, P. N. Odonkor, C. A. Young, M. J. Santos, J. S. Gottdiener, and B. P. Griffith Aortic Valve Bypass Surgery: Midterm Clinical Outcomes in a High-Risk Aortic Stenosis Population Circulation, September 30, 2008; 118(14): 1460 - 1466. [Abstract] [Full Text] [PDF]

				M. D. Peterson, M. A. Borger, C. M. Feindel, and T. E. David Aortic Annular Enlargement During Aortic Valve Replacement: Improving Results With Time Ann. Thorac. Surg., June 1, 2007; 83(6): 2044 - 2049. [Abstract] [Full Text] [PDF]

				W. Flameng, B. Meuris, P. Herijgers, and M.-C. Herregods Prosthesis-Patient Mismatch is Not Clinically Relevant in Aortic Valve Replacement Using the Carpentier-Edwards Perimount Valve Ann. Thorac. Surg., August 1, 2006; 82(2): 530 - 536. [Abstract] [Full Text] [PDF]

				P Pibarot and J G Dumesnil Prosthesis-patient mismatch: definition, clinical impact, and prevention Heart, August 1, 2006; 92(8): 1022 - 1029. [Abstract] [Full Text] [PDF]

				T. Walther, A. Rastan, V. Falk, S. Lehmann, J. Garbade, A. K. Funkat, F. W. Mohr, and J. F. Gummert Patient prosthesis mismatch affects short- and long-term outcomes after aortic valve replacement. Eur. J. Cardiothorac. Surg., July 1, 2006; 30(1): 15 - 19. [Abstract] [Full Text] [PDF]

				J. G. Dumesnil and P. Pibarot Prosthesis-patient mismatch and clinical outcomes: The evidence continues to accumulate J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 952 - 955. [Full Text] [PDF]

				M. Ruel, H. Al-Faleh, A. Kulik, K. L. Chan, T. G. Mesana, and I. G. Burwash Prosthesis-patient mismatch after aortic valve replacement predominantly affects patients with preexisting left ventricular dysfunction: Effect on survival, freedom from heart failure, and left ventricular mass regression J. Thorac. Cardiovasc. Surg., May 1, 2006; 131(5): 1036 - 1044. [Abstract] [Full Text] [PDF]

				G. Tasca, Z. Mhagna, S. Perotti, P. B. Centurini, T. Sabatini, A. Amaducci, F. Brunelli, M. Cirillo, M. D. Tomba, E. Quiani, et al. Impact of Prosthesis-Patient Mismatch on Cardiac Events and Midterm Mortality After Aortic Valve Replacement in Patients With Pure Aortic Stenosis Circulation, January 31, 2006; 113(4): 570 - 576. [Abstract] [Full Text] [PDF]