Document Detail

Prediction of postoperative exercise tolerance after aortic valve replacement.
MedLine Citation:
PMID:  7979726     Owner:  NLM     Status:  MEDLINE    
Valve size selection for aortic valve replacement is still a controversial matter, particularly in patients with small aortic annuli. To assess optimal valve size, exercise capacity, as measured by peak oxygen consumption levels, was determined in 39 patients (age range, 18 to 77 years; mean, 56 years) who underwent isolated aortic valve replacement with a St. Jude Medical valve. This assessment was carried out at a mean of 2.2 years post-operatively using ergometer exercise testing. These levels were evaluated as a measure of the percentage of predicted. At rest, there was no significant correlation between the predicted peak oxygen consumption and the pressure gradients across the prostheses, as measured by Doppler ultrasound. In 18 patients with aortic regurgitation, the preoperative dimensions of the left ventricle in end-diastole and end-systole correlated inversely (p < 0.05) with the percentage of predicted peak oxygen consumption. In 21 patients with aortic stenosis, the linear regression line (p < 0.01) was derived from the correlation between the percentage of predicted peak oxygen consumption and the valve area index (geometric valve orifice area/body surface area). We conclude that the preoperative end-systolic and end-diastolic dimensions should be less than 50 mm and 70 mm, respectively, in the setting of aortic regurgitation, and a valve area index, though it proved to be weakly correlated with the percentage of the peak oxygen uptake, should probably be more than 1.5 cm2/m2 in the setting of aortic stenosis to achieve good exercise capacity postoperatively (> 80% of predicted peak oxygen consumption).
K Hirooka; K Kawazoe; Y Kosakai; Y Sasako; K Eishi; Y Kito; N Nakanishi; T Yoshioka; Y Kawashima
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  58     ISSN:  0003-4975     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1994-12-28     Completed Date:  1994-12-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1626-30     Citation Subset:  AIM; IM    
Division of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Aortic Valve
Aortic Valve Insufficiency / physiopathology*,  surgery
Aortic Valve Stenosis / physiopathology*,  surgery
Exercise Tolerance*
Heart Valve Prosthesis*
Middle Aged
Oxygen Consumption*
Postoperative Period

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

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