Abstract
BackgroundAortic valve neocuspidization (AVNeo) has emerged as a promising aortic valve procedure, and is expected to have a larger effective orifice area (EOA) than commercially available bioprostheses. It is, however, unclear which indices could facilitate left ventricular (LV) reverse remodeling after AVNeo. The aim of this study is to verify the impact of global left ventricular afterload on the LV reverse remodeling following AVNeo.MethodsData-available consecutive 38 patients (median age, 77; interquartile range, 72.8–82.0) undergoing AVNeo for severe aortic stenosis were enrolled in this study. Preoperative and the last follow-up echocardiographic data were retrospectively analyzed including the valvuloarterial impedance (Zva), a marker of global LV afterload. Reduction in LV geometry index (LVGI) and relative wall thickness (RWT) were used as an indicator for LV reverse remodeling.ResultsThe Zva reduced in 24 patients (63.2%) during the follow-up period (median, 12 months). Reduction in Zva significantly correlated to improvement of LV geometry (LVGI (r = 0.400, p = 0.013) and RWT (r = 0.627, p < 0.001)), whereas increase in EOA index did not significantly correlate to LVGI (r = 0.009, p = 0.957), or RWT (r = 0.105, p = 0.529)). The reduction in Zva was the multivariate predictor of LV reverse remodeling.ConclusionsLow global LV afterload led to significant LV reverse remodeling even after AVNeo, which could achieve better valve performance than the conventional bioprostheses.
Highlights
Left ventricular hypertrophy (LVH) is a well-recognized risk factor of left ventricular (LV) dysfunction independent of the severity of the valvular load in patients with severe aortic valve stenosis (AS) [1]
We have reported that low Valvuloarterial impedance (Zva) facilitated LV reverse remodeling after an increased LV wallAortic valve replacement (AVR) with externally wrapped bioprosthetic valves [8]
The aortic annular motion was preserved even after Aortic valve neocuspidization (AVNeo) and the dynamic changes of annular diameter during the cardiac cycle increased more than the preoperative status. It has been unclear whether large effective orifice area (EOA) itself could solely contribute to LV reverse remodeling after AVNeo
Summary
Left ventricular hypertrophy (LVH) is a well-recognized risk factor of left ventricular (LV) dysfunction independent of the severity of the valvular load in patients with severe aortic valve stenosis (AS) [1]. Aortic valve replacement (AVR) could facilitate LV reverse remodeling with increased effective orifice area (EOA). It is hypothesized that low global LV afterload may have a positive effect on LV reverse remodeling even after AVNeo. The purpose of this study is to verify the impact of global LV afterload on LV reverse remodeling following AVNeo for AS patients. Aortic valve neocuspidization (AVNeo) has emerged as a promising aortic valve procedure, and is expected to have a larger effective orifice area (EOA) than commercially available bioprostheses. It is, unclear which indices could facilitate left ventricular (LV) reverse remodeling after AVNeo. The aim of this study is to verify the impact of global left ventricular afterload on the LV reverse remodeling following AVNeo
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
