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J Thorac Cardiovasc Surg 1998;116:590-598
© 1998 Mosby, Inc.
SURGERY FOR ADULT CARDIOVASCULAR DISEASE |
Rome, Italy
From the Cardiac Surgery Department, Tor Vergata University of Rome, Italy.
Received for publication Dec 22, 1997. Revisions requested Jan 29, 1998; revisions received May 26, 1998. Accepted for publication May 28, 1998. Address for reprints: Ruggero De Paulis, MD, Cattedra di Cardiochirurgia, Università di Roma, Tor Vergata, European Hospital, via Portuense 700, 00149 Rome, Italy.
Objective: Stentless biologic aortic valves are less obstructive than stented biologic or mechanical valves. Their superior hemodynamic performances are expected to reflect in better regression of left ventricular hypertrophy. We compared the regression of left ventricular hypertrophy in 3 groups of patients undergoing aortic valve replacement for severe aortic stenosis. Group I (10 patients) received stentless biologic aortic valves, group II (10 patients) received stented biologic aortic valves, and group III (10 patients) received bileaflet mechanical aortic valves.
Methods: Echocardiographic evaluations were performed before the operation and after 1 year, and the results were compared with those of a control group. Left ventricular diameters and function, left ventricular wall thickness, and left ventricular mass were assessed by echocardiography.
Results: Group I patients had a significantly lower maximum and mean transprosthetic gradient than the other valve groups (P = .001). One year after operation there was a significant reduction in left ventricular mass for all patient groups (P < .01), but mass did not reach normal values (P = .05). Although the rate of regression in the interventricular septum and posterior wall thickness differed slightly among groups, their values at follow-up were comparable and still higher than control values (P = .002). The ratio between interventricular septum and posterior wall and the ratio between wall thickness and chamber radius did not change significantly at follow-up.
Conclusions: Because the number of patients was relatively small, we could not use left ventricular mass regression after 1 year to distinguish among patients undergoing aortic valve replacement for aortic stenosis by means of valve prostheses with different hemodynamic performances.
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