0316: Assessment of left ventricular mass regression after implantation of a new generation of sutureless aortic bioprosthesis

Abstract

The development of left ventricular (LV) concentric hypertrophy in the natural course of aortic stenosis is known as an independent prognostic factor of morbidity and mortality. The regression of LV mass after aortic valve replacement leads to an improvement of functional capacity and long-term outcome. To assess the degree of LV mass regression at one month after implantation of Edwards INTUITY. Single arm, prospective study, from July 2012 to March 2014. Echocardiography was performed preoperatively, at discharge and at one-month follow up. Inclusion criteria: 1/ Severe symptomatic aortic stenosis 2/ tricuspid aortic valve.Endpoints:1/ In hospital mortality 2/ Evolution of LVEF, IVSd and LVPWd 3/ Evolution of LV mass index 4/ Evolution of mean gradient and iEOA 5/Incidence of periprosthetic regurgitation (PPR) 72 patients, age = 77.4±6.6, BMI = 31.2±4.2, Euroscore II= 3.4±3.4, LVEF = 63.4±10.2%, Aortic valve area = 0.5±0.2 cm2, Mean gradient = 56.7±19.3mmHg, Stroke volume = 49.9±11.6 ml/m2, full sternotomy in all, associated CABG in 23 patients (33%), Cross clamping time = 48.7±22.3. 1/ In-hospital mortality: 1.4%. 2/ Evolution of LV parameters: LVEF(%) remains stable (61.6±8.9 versus 61.8±7.5, p=0.08), IVSd(mm) and LVPWd (mm) significantly decreased ((13.5±2 vs 14.9±1.7, p<0.001) and (12.5±1.5 vs 15.3±1.4, p< 0.001)). 3/ Evolution of LV mass index: LV mass index ( mg/m2) significantly decreased at one month FU(124.4±26.7 vs 167±45.1, p<0.001) 4/ Evolution of mean gradient and iEOA: Mean gradient (mmHg): 12.3±7.10 vs 56.7±19.3, p< 0.001 iEOA(cm2/m2): 1±0.4 vs 0.5±0.2, p<0.001 5/ Incidence of PPR No moderate or severe paravalvular leakage was observed at discharge and at follow-up. Edwards’s Intuity bioprosthesis provides favorable preliminary results and is associated with significant regression of LV mass during the first month after aortic valve replacement.Midterm results should be evaluated.