Evaluation of Left Ventricular Function and Mass after Medtronic Freestyle versus Homograft Aortic Root Replacement using Cardiovascular Magnetic Resonance
Kim Rajappan MRCP, Giovanni Melina MD, Nicholas G. Bellenger MRCP, Mohamed Amrani FRCS, Asghar Khaghani FRCS, Dudley J. Pennell FRCP, Magdi H. Yacoub FRS

Although traditionally, regression of left ventricular mass after aortic valve replacement (AVR) has been assessed with echocardiography, the greater accuracy and reproducibility of cardiovascular magnetic resonance (CMR) can provide more meaningful information. Left ventricular mass index (LVMI) was measured using CMR in patients from a prospective randomized trial comparing homograft (n = 8) with xenograft root replacement (n = 9). Both groups showed significant regression at one year postoperatively (homograft LVMI 145 ± 44 g/m² preoperative versus 83 ± 23 g/m² one year postoperative; xenograft LVMI 140 ± 28 g/m² versus 93 ± 21 g/m², respectively). At six months there was significant regression in the xenograft group, but not in the homograft group. The extent and pattern of left ventricular mass regression were demonstrated using CMR after homograft and, for the first time, the Medtronic Freestyle xenograft full root replacement technique.