The effect of preoperative left ventricular filling patterns on prognosis in patients with aortic valve replacement
Turkiye Klinikleri Journal of Medical Sciences, cilt.26, sa.3, ss.258-264, 2006 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 26 Sayı: 3
- Basım Tarihi: 2006
- Dergi Adı: Turkiye Klinikleri Journal of Medical Sciences
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.258-264
- Anahtar Kelimeler: Aortic valve, Heart valve prosthesis, Hypertrophy, Left ventricular
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Although many studies have been performed to evaluate the effects of a variety of heart valves on left ventricular function, the alterations in diastolic function seen in patients with preoperatively restrictive filling patterns after aortic valve replacement (AVR) with various mechanical, stented or stentless prosthesis have not been sufficiently examined. This study aimed to assess and compare the changes in diastolic function in such patients following AVR. Material and Methods: In accordance with preoperative echocardiographic findings in patients of similar age groups and body size, 24 patients were selected as having restrictive filling patterns (i.e. deceleration time (DT)≤150 msec, iso-volumetric relaxation time (IVRT)<100 msec). The patients underwent AVR with either St. Jude Medical (SJM) (n= 8) or CarboMedics (CM) mechanical valves (n= 6), or Medtronic Freestyle® (MF) (n= 6) or CryoLife-O'Brien (CO) (n= 4) stentless bioprotheses. Another 24 patients were selected as a non-restrictive, physiologic group. The effect of valve replacement on diastolic parameters was evaluated preoperatively and postoperatively at discharge and after 4 and 8 weeks by comparing the parameters before and after valve replacement. Results: Improvement in DT, IVRT and ejection fraction occurred in all patients with restrictive filling patterns irrespective of valve type. Although the difference between the various types was not statistically significant, left ventricular mass regression was higher in patients with mechanical valves. Conclusion: Preoperatively determined restrictive patterns appear to convey more benefit than that derived by patients with preoperative non-restrictive filling patterns. A greater improvement is to be expected in more advanced disease states in patients following AVR. Copyright © 2006 by Türkiye Klinikleri.