Hemodynamic and angiographic evaluation of aortic regurgitation 8 and 27 months after aortic valve replacement

Eighteen patients with chronic aortic insufficiency were evaluated hemodynamically and angiographically 8 months after aortic valve replacement. Both the pulmonary artery diastolic pressure and the left ventricular end-diastolic volume decreased significantly (p less than 0.001), but the mean ejecti...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1981-09, Vol.64 (3), p.456-463
Main Authors: Toussaint, C, Cribier, A, Cazor, J L, Soyer, R, Letac, B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aortic Valve - diagnostic imaging
Aortic Valve - transplantation
Aortic Valve Insufficiency - physiopathology
Aortic Valve Insufficiency - surgery
Cardiac Output
Diastole
Evaluation Studies as Topic
Female
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Hemodynamics
Humans
Male
Middle Aged
Postoperative Period
Prognosis
Pulmonary Artery
Radiography
Stroke Volume
Systole
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Summary:Eighteen patients with chronic aortic insufficiency were evaluated hemodynamically and angiographically 8 months after aortic valve replacement. Both the pulmonary artery diastolic pressure and the left ventricular end-diastolic volume decreased significantly (p less than 0.001), but the mean ejection fraction and the cardiac output remained identically lowered, though some individual cases showed improvement. The relative reduction in end-diastolic volume correlated only with the preoperative ejection (p less than 0.05) and regurgitation fractions (p less than 0.02). In the 10 patients whose left ventricular volume remained high or ejection fraction low, a second evaluation was performed 27 months after surgery. The left ventricular end-diastolic volume was significantly lowered (from 151 to 120 ml/m2, p less than 0.05) back to normal in five cases. The systolic and diastolic ventricular shape returned to normal. Cardiac index and ejection fraction were unchanged. These results show a marked improvement a few months after aortic valve replacement, with a further improvement several months later, as shown mainly by the decrease of left ventricular end-diastolic volume and the return to normal of left ventricular cavity shape. However, in most cases, the ejection fraction remained at its preoperative valve, suggesting that surgery should be performed early, before myocardial deterioration appears.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.64.3.456