Reduction of Left Ventricular Hypertrophy after Aortic Valve Replacement for Isolated Aortic Valve Stenosis

Abstract

Background: : : :Residual left ventricular hypertrophy adversely affects long-term outcome after aortic valve replacement. Despite technical advances of increasing prosthesis orifice area, small valves implanted in the unenlarged aortic root may not be significantly less obstructive than the stenotic native valves they replace. Method:Forty patients receiving single aortic valve replacement for isolated aotic valve stenosis(without other valvular diseases and coronary artery diseases were enrolled in this study. The operation was performed from Jan. 1990 to July 1996 in Yonsei Cardiovascular Center. They were implanted with 19, 21, 23, 25mm size valves. Twenty nine were men, and the mean age was 53.3±11.1 years(mean±standard deviation, range 27 to 70 years, and the follow-up duration was 29.5±19.5 months(range 12 to 86 months. Echocardiographic studies were perfo- rmed before and more than 1 year after the operation. We reviewed the medical histories, clinical symptoms, and echocardiography Results: 1 The etiology of aotic valve stenosis were congenital bicuspid valve(18 cases, 45%, degen- erative(9 cases, 23%, rheumatic heart disease(8 cases, 20%, and others(5 cases, 13%. Clinical symptoms were dyspnea(39 cases, 98%, angina(19 cases, 45%, and sycope(3 case, 8%. The patients were divided into 19mm group(9 cases, 23%, 21mm group(16 cases, 40%, 23mm group (9 cases, 23%, and 25mm group(6 cases, 15%. The patients replaced with valves of smaller size had significantly smaller surface areas than those replaced with the larger valves. 2 The preoperative LV mass index of smaller valve groups was larger when compared to the larger valve groups. LV mass and mass index decreased in all four groups(albeit significantly in the 19 and 21mm groups, and without significance in the 23 and 25mm groups. LVEDD, IVST,