Stentless vs. Stented Aortic Valve Replacement: Left Ventricular Mass Regression

2005 ◽  
Vol 13 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Muhammed Tamim ◽  
Thierry Bové ◽  
Yves Van Belleghem ◽  
Katrien François ◽  
Yves Taeymans ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Ventricular Mass Index ◽  
Statistical Significance ◽  
Left Ventricular ◽  
Ventricular Mass Index ◽  
Ventricular Mass

The aim of this retrospective study was to evaluate the time-related regression of left ventricular hypertrophy after stentless vs. stented aortic valve replacement. From January 1992 to December 2002, 145 patients had a Toronto stentless porcine valve and 106 had a stented Carpentier-Edwards aortic valve replacement. Over a 10-year follow-up, survival was superior in the Toronto group vs. the Carpentier-Edwards group (84% vs. 74% at 4 years; 78% vs. 68% at 6 years; p < 0.001). A significant and constant reduction of peak and mean transvalvular gradients after valve replacement resulted in substantial regression of left ventricular mass index in both groups, which did not reach statistical significance. However, this phenomenon stopped at 3 years, and left ventricular mass index increased slowly after 5 years. Stentless and stented bioprostheses both showed good early and late clinical and hemodynamic outcomes, with the advantage of better midterm survival for stentless xenografts.

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 Regression of Left Ventricular Mass after Implantation of the Sutureless 3f Enable Aortic Bioprosthesis

2015 ◽  
Vol 42 (2) ◽  
pp. 117-123
Author(s):  
Giovanni Concistrè ◽  
Antonio Miceli ◽  
Federica Marchi ◽  
Francesca Chiaramonti ◽  
Mattia Glauber ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Mass ◽  
The Mean

Left ventricular hypertrophy in aortic stenosis is considered a compensatory response for the maintenance of systolic function but a risk factor for cardiac morbidity and death. We investigated the degree of left ventricular mass regression after implantation of the sutureless Medtronic 3f Enable® Aortic Bioprosthesis. We studied 19 patients who, from May 2010 through July 2011, underwent isolated aortic valve replacement with the 3f Enable bioprosthetic valve, with clinical and echocardiographic follow-up at 6 months. The mean age was 77.1 ± 5.1 years (range, 68–86 yr); 14 patients were women (73.7%); and the mean logistic EuroSCORE was 15.4% ± 11.8%. Echocardiography was performed preoperatively, at discharge, and at 6 months' follow-up. The left ventricular mass was calculated by means of the Devereux formula and indexed to body surface area. The left ventricular mass index decreased from 146.1 ± 47.6 g/m2 at baseline to 118.1 ± 39.8 g/m2 at follow-up (P=0.003). The left ventricular ejection fraction did not change significantly. The mean transaortic gradient decreased from 57.3 ± 14.2 mmHg at baseline to 12.3 ± 4.6 mmHg at discharge and 12.2 ± 5.3 mmHg at follow-up (P &lt;0.001), and these decreases were accompanied by substantial clinical improvement. No moderate or severe paravalvular leakage was present at discharge or at follow-up. In isolated aortic stenosis, aortic valve replacement with the 3f Enable bioprosthesis results in significant regression of left ventricular mass at 6 months' follow-up. However, this regression needs to be verified by long-term echocardiographic follow-up.

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.

scholarly journals Left ventricular mass index in aortic valve surgery: a new index for early valve replacement?☆

2003 ◽  
Vol 23 (5) ◽  
pp. 696-702 ◽  
Author(s):  
Rafael Garcı́a Fuster ◽  
José A.Montero Argudo ◽  
Oscar Gil Albarova ◽  
Fernando Hornero Sos ◽  
Sergio Cánovas López ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Mass ◽  
Valve Replacement ◽  
Left Ventricular Mass Index ◽  
Left Ventricular ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Ventricular Mass Index ◽  
Ventricular Mass
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