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You are here: Contents > 2012 > Volume 21 Number 6 November 2012 > MISCELLANEOUS > Left Ventricular Mass Regression is Independent of Gradient Drop and Effective Orifice Area after Aortic Valve Replacement with a Porcine Bioprosthesis

Left Ventricular Mass Regression is Independent of Gradient Drop and Effective Orifice Area after Aortic Valve Replacement with a Porcine Bioprosthesis

Justo Rafael Sádaba, Marie-Christine Herregods, Jan Bogaert, Wolfgang Harringer, Gino Gerosa
Department of Cardiac Surgery, Hospital de Navarra, Pamplona, Spain, Departments of Cardiology and Radiology, University Hospital Leuven, Leuven, Belgium, Department of Thoracic and Cardiovascular Surgery, Klinikum Braunschweig, Braunschweig, Germany, Institute for Cardiovascular Surgery, Policlino Universitario, Padua, Italy

Background and aim of the study: The question of whether left ventricular mass (LVM) regression following aortic valve replacement (AVR) is affected by the prosthesis indexed effective orifice area (IEOA) and transprosthetic gradient has not been fully elucidated. Data from a prospective, core-laboratory-reviewed echocardiography and magnetic resonance imaging (MRI) study was used to determine if the degree of LVM regression following AVR with two types of porcine bioprosthesis in patients suffering from predominant aortic valve stenosis (AS) was related to the prosthesis IEOA and transprosthetic gradient.
Methods: Over a two-year period, 149 patients enrolled at eight centers received either an Epic™ or an Epic Supra™ aortic bioprosthesis (St. Jude Medical, MN, USA). Preoperative valve dysfunction was pure AS in 54 patients (36%) and mixed valve disease (primarily stenosis) in 95 patients (64%). LVM was determined preoperatively and at six

months postoperatively, using MRI. The prosthesis IEOA and transprosthetic gradient were calculated at six months by means of echocardiography.
Results: Data were available for 111 patients at both enrolment and six months postoperatively. The LVM at enrolment and at follow up was 154.96 ± 42.50 g and 114.83 ± 29.20 g, respectively (p <0.0001). An analysis of data using Spearman rank correlation coefficients and linear regression methods, showed LVM regression to be independent of the mean systolic pressure gradient, peak systolic pressure and prosthesis IEOA at six months (p = 0.53, 0.43, and 0.15, respectively).
Conclusion: At six months after AVR with a porcine bioprosthesis to treat AS, there was a significant LVM regression that was independent of the prosthesis IEOA and the mean systolic pressure gradient and peak systolic pressure.

The Journal of Heart Valve Disease 2012;21:788-794

Left Ventricular Mass Regression is Independent of Gradient Drop and Effective Orifice Area after Aortic Valve Replacement with a Porcine Bioprosthesis

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