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KMID : 0191119990140050511
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Journal of Korean Medical Science
1999 Volume.14 No. 5 p.511 ~ p.519
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Left ventricular muscle mass regression after aortic valve replacement
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Lee JW
Choi KJ/Lee SG/Choo SJ/Kim JO/Kang DH/Song JK/Song MG
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Abstract
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Implanting a valve that will reduce left ventricular mass is critical in aortic stenosis. Regression of
left ventricular hypertrophy in 46 aortic valve replacement (AVR) patients receiving a St. Jude Medical
(SJM) valve was assessed by serial electrocardiographic and echocardiographic studies during the preoperative,
immediate, and late postoperative periods. The patients were divided into three groups according to valve
size; 19 mm group (n=9), 21 mm group (n=20), and 23+mm group (n=17). There was no surgical mortality. The
NYHA functional class improved from an average of 2.2+/-0.8 preoperatively to 1.3+/-0.5 post-operatively.
Left ventricular muscle mass index (LVMI) regression failed to reach statistical significance in the 19 mm
group, whereas in the other two groups a steady decrease in the LVMI occurred with follow up. ECG findings
were less remarkable showing insignificant differences in voltage among the three groups (p=0.000). In
conclusion, the current data suggest that the 19 mm SJM valve may not result in satisfactory left ventricular
muscle mass regression despite adequate function, even in small patients. Therefore, additional procedures to
accommodate a larger valve may be warranted in the aortic annulus smaller than 21 mm.
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