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Cardiac energetics analysis after aortic valve replacement with 16-mm ATS mechanical valve.
MedLine Citation:
PMID:  24859744     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The 16-mm ATS mechanical valve is one of the smallest prosthetic valves used for aortic valve replacement (AVR) in patients with a very small aortic annulus, and its clinical outcomes are reportedly satisfactory. Here, we analyzed the left ventricular (LV) performance after AVR with the 16-mm ATS mechanical valve, based on the concept of cardiac energetics analysis. Eleven patients who underwent AVR with the 16-mm ATS mechanical valve were enrolled in this study. All underwent echocardiographic examination at three time points: before AVR, approximately 1 month after AVR, and approximately 1 year after AVR. LV contractility (end-systolic elastance [Ees]), afterload (effective arterial elastance [Ea]), and efficiency (ventriculoarterial coupling [Ea/Ees] and the stroke work to pressure-volume area ratio [SW/PVA]) were noninvasively measured by echocardiographic data and blood pressure measurement. Ees transiently decreased after AVR and then recovered to the pre-AVR level at the one-year follow-up. Ea significantly decreased in a stepwise manner. Consequently, Ea/Ees and SW/PVA were also significantly improved at the one-year follow-up compared with those before AVR. The midterm LV performance after AVR with the 16-mm ATS mechanical valve was satisfactory. AVR with the 16-mm ATS mechanical valve is validated as an effective treatment for patients with a very small aortic annulus. The cardiac energetics variables, coupling with the conventional hemodynamic variables, can contribute to a better understanding of the patients' clinical conditions, and those may serve as promising indices of the cardiac function.
Authors:
Tomoki Ushijima; Yoshihisa Tanoue; Takayuki Uchida; Sho Matsuyama; Takashi Matsumoto; Ryuji Tominaga
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-25
Journal Detail:
Title:  Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs     Volume:  -     ISSN:  1619-0904     ISO Abbreviation:  J Artif Organs     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9815648     Medline TA:  J Artif Organs     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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