Document Detail


Does the type of prosthesis influence early left ventricular mass regression after aortic valve replacement? Assessment with magnetic resonance imaging.
MedLine Citation:
PMID:  14564336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Debate exists regarding selection of the prosthesis type most likely to maximize early left ventricular (LV) mass regression after aortic valve replacement (AVR) for stenotic valvular disease. The aim of this study was to compare the degree of LV mass regression measured by MRI 6 months after prospectively randomized valve implantation for two biological prostheses, stented and stentless, and for two mechanical valves, tilting disc and bileaflet. METHODS: Thirty-nine consecutive patients with predominant aortic stenosis accepted for elective AVR were studied. Twenty patients requiring a tissue prosthesis were randomly assigned to receive either a Freestyle or Mosaic valve. The remaining 19 patients in whom mechanical prosthesis was indicated were randomly assigned to receive either an Ultracor or an ATS valve. RESULTS: There was no difference in valve size implanted between the compared groups. LV mass measurements were performed with MRI (1.5-T Vision, Siemens, Germany) immediately before and 6 months after surgery. All valve types produced significant postoperative reduction in LV mass compared with preoperative values (P <.01). Percent change in LV mass regression was similar between the two porcine valve types, Mosaic (24.4% +/- 11.1%) and Freestyle (21.1% +/- 16.7%), and between the two mechanical valve designs, Ultracor (19.3% +/- 9.5%) and ATS (26.3% +/- 10.8%), respectively. CONCLUSIONS: Significant LV remodeling occurs early after AVR for aortic stenosis. The degree of regression in LV mass is independent of prosthesis type implanted.
Authors:
Penelope R Sensky; Mahmoud Loubani; Richard P Keal; Nilesh J Samani; Andrew W Sosnowski; Manuel Galiñanes
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  146     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-10-17     Completed Date:  2003-11-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E13     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, University of Leicester, Leicester, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aortic Valve / surgery*
Aortic Valve Stenosis / surgery*
Bioprosthesis
Female
Heart Valve Prosthesis*
Heart Valve Prosthesis Implantation*
Humans
Hypertrophy, Left Ventricular / diagnosis,  physiopathology,  surgery*
Magnetic Resonance Imaging
Male
Middle Aged
Prospective Studies
Prosthesis Design
Remission Induction
Ventricular Remodeling*
Comments/Corrections
Comment In:
Am Heart J. 2004 Nov;148(5):e19   [PMID:  15523297 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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