Assessment of Left Atrial Volume, Indexed Left Atrial Volume and Left Ventricular Mass Index Post Percutaneous Aortic Valve Replacement

2008 ◽  
Vol 17 ◽  
pp. S27
Author(s):  
Emma Ivens ◽  
Robert Moss ◽  
Bradley Munt ◽  
Christopher Thompson ◽  
Sanjeevan Pasuputi
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Ventricular Mass Index ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Atrial Volume ◽  
Percutaneous Aortic Valve Replacement

scholarly journals P1518 Relationship between post-operative asymptomatic status and reverse remodeling of large left atrium in patients with aortic stenosis who underwent aortic valve replacement

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
T Hozumi ◽  
J Morimoto ◽  
T Nishi ◽  
K Takemoto ◽  
S Fujita ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Volume Index ◽  
Reverse Remodeling ◽  
Atrial Volume

Abstract Introduction Recently, we have reported that large left atrial volume (minimum left atrial volume index : LAVImin ≥30ml/m²) at end-diastole determined by direct exposure of left ventricular (LV) end-diastolic pressure can predict post-operative symptomatic status after aortic valve replacement (AVR) in aortic stenosis (AS) patients with high sensitivity and modest specificity. Reverse remodeling of large LAVImin after AVR may contribute to false positive for the prediction of post-operative symptomatic status in patients with AS. Purpose The purpose of this study was to evaluate relationship between post-operative symptomatic status and reverse remodeling of large LAVImin in patients with AS who underwent AVR. Methods The study population consisted of 75 patients with AS who underwent AVR and were followed up for 600 days after AVR, after the exclusion of the followings; atrial fibrillation, significant coronary artery disease, significant mitral valve disease, pacemaker rhythm, and inadequate echocardiographic images. We measured LAVImin by biplane Simpson"s method before and after AVR. Preoperative large LAVImin (≥30ml/m²) according to the previous study was observed in 32 (43%) of 75 patients. We divided these 32 patients into two groups according to the post-operative symptomatic status during the follow-up period. Results There was no significant difference in pre-operative LAVImin between patients with and without post-operative symptom (46.5 ± 13.4 vs 40.4 ± 8.6 ml/m²). On the other hand, post-operative LAVImin in patients without post-operative symptom was significantly smaller than that in patients with post-operative symptom (31.5 ± 8.6 vs 54.8 ± 14.0 ml/m², p < 0.01). While significant regression in LAVImin after AVR was observed in patients without post-operative symptom (40.4 ± 8.6 to 31.5 ± 8.6 ml/m², p < 0.05), no regression in LAVImin after AVR was observed in patients with post-operative symptom (46.5 ± 13.4 to 54.8 ± 14.0 ml/m²). Conclusions Reverse remodeling of large LAVmin in patients with AS who underwent AVR was observed in post-operative asymptomatic group, but not in symptomatic group. These results suggest that reverse remodeling of large LAVImin after AVR could contribute to the post-operative asymptomatic status in patients with AS who underwent AVR.

Left Atrial Volume and Post-Operative Atrial Fibrillation after Aortic Valve Replacement

2010 ◽  
Vol 2 (3) ◽  
Author(s):  
Madhu Reddy Yeruva ◽  
Ruby Satpathy ◽  
Xuedong Shen ◽  
Mark Holmberg ◽  
Claire Hunter ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Atrial Volume ◽  
Post Operative Atrial Fibrillation

scholarly journals Postoperative atrial fibrillation after aortic valve replacement is a risk factor for long-term atrial fibrillation

2019 ◽  
Vol 29 (3) ◽  
pp. 378-385 ◽  
Author(s):  
Rasmus Carter-Storch ◽  
Jordi S Dahl ◽  
Nicolaj L Christensen ◽  
Redi Pecini ◽  
Eva V Søndergård ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index

AbstractOBJECTIVESPostoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. However, knowledge on the rate of long-term atrial fibrillation (LTAF) after POAF remains unclear. We investigated predictors of POAF in patients with aortic stenosis undergoing surgical aortic valve replacement, and assessed the rate of LTAF during follow-up.METHODSWe prospectively included 96 adult patients with severe aortic stenosis undergoing surgical aortic valve replacement. Patients with previous atrial fibrillation (AF) were excluded. Patients underwent echocardiography, cardiac computed tomography and magnetic resonance imaging immediately prior to surgery. Surgical aortic clamp time and postoperative C-reactive protein (CRP) were documented. POAF was defined as AF recorded within 7 days of surgery. Through chart review, patients were followed up for documented episodes of LTAF occurring more than 7 days after surgery.RESULTSPOAF occurred in 51 patients (53%). It was associated with larger preoperative echocardiographic left atrial volume index (44 ± 12 vs 37 ± 8 ml/m2, P = 0.004), longer aortic clamp time [80 (70–102) vs 72 (62–65) min, P = 0.04] and higher CRP on first postoperative day [80 (64–87) vs 65 (44–83) mg/l, P = 0.001]. Multivariable logistic regression revealed that left atrial volume index [odds ratio (OR) 1.07, 95% confidence interval (CI) 1.02–1.13; P = 0.005] and postoperative CRP (OR 1.03, 95% CI 1.01–1.05; P = 0.006) were the only independent predictors of POAF. During 695 days (25th–75th percentile: 498–859 days) of follow-up, LTAF occurred in 11 patients of whom 10 were in the POAF group (hazard ratio 9.4, 95% CI 1.2–74; P = 0.03).CONCLUSIONSPOAF is predicted by left atrial volume index and postoperative CRP. Patients with POAF have a 9-fold increase risk of developing symptomatic LTAF during follow-up.Clinical trial registration numberClinicalTrials.gov (NCT02316587).

scholarly journals Myocardial protection technique structured on cardiac mass

Perfusion ◽  
2019 ◽  
Vol 35 (5) ◽  
pp. 371-377
Author(s):  
Ignazio Condello ◽  
Patrizio Lancellotti ◽  
Giuseppe Speziale
Keyword(s):  
Cardiac Surgery ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Myocardial Protection ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
P Value ◽  
Ventricular Mass Index

Objective: Myocardial protection is crucial in cardiac surgery: quantification is often difficult as there is a significant mismatch between body weight and heart weight as per geometric remodeling. This study has the objective to compare two groups of patients on the administration of myocardial protection in valvular pathologies: the first group has indexed the administration with left ventricular mass index; the second has indexed it on the body weight or on the body surface area. The primary endpoint of double-blind case-control study is to detect the difference in incidence in terms of post-operative low cardiac output syndrome. Methods: A single-center double-blind case-control study in a specialized regional tertiary cardiac surgery center in Italy. Between March 2017 and September 2018, 200 adults (100 per Group A vs. Group B) were scheduled for elective procedures: Group A (50 aortic valve replacement-50 mitral valve repair in minimally invasive cardiac surgery) used blood cardioplegic solution with Saint Thomas I solution, with calculation of left ventricular mass index with echocardiographic measures (Formula Group A); Group B (50 aortic valve replacement-50 mitral valve repair in minimally invasive cardiac surgery) used blood cardioplegic solution with Saint Thomas I solution, with calculation indexed on the body surface area, Du Bois Method (Formula Group B). Results: A statistically significant difference was found for Student’s t-test in patients who used myocardial indexed protection on left ventricular mass index versus control: aortic valve replacement procedures in aortic valve stenosis—ejection fraction (24 hours, p-value = 0.046), TnT (24 hours, p-value = 0.047), stroke volume shift (24 hours, p-value = 0.043), and infusion of epinephrine after cardiopulmonary bypass (p-value = 0.033); aortic valve replacement procedures in aortic valve insufficiency—ejection fraction (24 hours, p-value = 0.044), TnT (24 hours, p-value = 0.047), stroke volume shift (24 hours, p-value = 0.046), and infusion of Epinephrine after cardiopulmonary bypass (p-value = 0.029). No statistically significant differences in patients undergoing mitral valve repair surgery. Conclusion: The study group in the aortic valve surgery that administered myocardial protection indexed for the left ventricular mass index and showed a statistically significant lower incidence for post-operative low cardiac output syndrome compared to the control group.

Aortic Valve Replacement with Toronto SPV in Elderly Patients: 10-Year Results

2005 ◽  
Vol 13 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Muhammed Tamim ◽  
Thierry Bové ◽  
Yves Van Belleghem ◽  
Frank Caes ◽  
Katrien François ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Elderly Patients ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
Actuarial Survival ◽  
Ventricular Mass Index ◽  
Ventricular Mass

A retrospective assessment of clinical and echocardiographic variables was performed in 145 patients who received a Toronto SPV aortic valve replacement. The majority (90%) of these elderly patients (mean age, 75.5 ± 7.4 years) were preoperatively in New York Heart Association class III–IV. Operative mortality was 4.8%. Follow-up was complete up to 10 years and revealed few valve-related complications: thromboembolism (7), bleeding (4), and prosthesis dysfunction necessitating reoperation (3). Late mortality was cardiac-related in 11.7% and noncardiac-related in 17.2%. Actuarial survival was 83% at 5 years and 63% at 8 years. Echocardiography showed low transvalvular gradients (peak, 17.5 ± 7.5 mm Hg; mean, 9.2 ± 4.2 mm Hg) resulting in a significant reduction in left ventricular mass index during the first 3 years. Independent of the transprosthetic gradient, left ventricular mass index tended to increase again beyond the 5th year, which correlated positively with the presence of arterial hypertension in this older population. The Toronto SPV bioprosthesis offers an aortic valve substitute with excellent long-term hemodynamics, resulting in significant early left ventricular mass regression. Considering the limitations of this selected elderly population, the clinical outcome and survival up to 10 years are encouraging, with few observed valve-related events.

scholarly journals The relation between blood pressure components and left atrial volume in the context of left ventricular mass index

Medicine ◽  
2017 ◽  
Vol 96 (52) ◽  
pp. e9459 ◽  
Author(s):  
Marta Rojek ◽  
Marek Rajzer ◽  
Wiktoria Wojciechowska ◽  
Jerzy Gąsowski ◽  
Tomasz Pizoń ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Left Ventricular Mass ◽  
Left Atrial ◽  
Left Ventricular Mass Index ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Atrial Volume ◽  
Ventricular Mass Index ◽  
Ventricular Mass
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