Document Detail


Postoperative left ventricular mass regression after aortic valve replacement for aortic stenosis.
MedLine Citation:
PMID:  20172120     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Small valve size and prosthetic patient mismatch are both considered to have harmful effects on residual left ventricular hypertrophy after aortic valve replacement for aortic stenosis. In general, it is believed that the effective orifice area index of the prosthesis must not be less than 0.85 cm(2)/m(2) in order to avoid prosthetic patient mismatch. On the other hand, studies have shown that valve type and valve size had no effects on postoperative left ventricular mass (LVM). The objective of this report was to examine the relationships between patient characteristics or the prosthetic valve and postoperative LVM. METHODS: To evaluate the factors that influence postoperative LVM, we formulated the hypothesis that postoperative LVM is proportional to the sum total of pressure at the prosthetic valve orifice and inner surface area of the left ventricle in systole. We present a conceptually new index for postoperative LVM and compare the index with postoperative LVM. RESULTS: The results indicated a strong correlation between the new index and postoperative LVM six years after surgery (r(2) =0.67, p < 0.0001). As might be expected, LVM increased gradually as the value of the new index increased. CONCLUSIONS: The results of the present study indicate that postoperative left ventricular hypertrophy can be avoided by preventing postoperative hypertension in patients without left ventricular dilatation and an effective orifice area index is greater than 0.77 cm(2)/m(2).
Authors:
Hiroshi Tomoeda; Tomohiro Ueda; Hideki Teshima; Koichi Arinaga; Keiichiro Tayama; Shuji Fukunaga; Shigeaki Aoyagi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  89     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-22     Completed Date:  2010-03-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  745-50     Citation Subset:  AIM; IM    
Copyright Information:
2010 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Kurume University Hospital, Kurume, Fukuoka, Japan. tomoeda_hiroshi@kurume-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aortic Valve / surgery*
Aortic Valve Stenosis / physiopathology,  surgery*
Echocardiography
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / adverse effects*
Heart Ventricles / ultrasonography
Humans
Hypertrophy, Left Ventricular / complications,  physiopathology*,  ultrasonography
Male
Middle Aged
Myocardial Contraction

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


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