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摘要
BackgroundLeft ventricular (LV) reverse remodeling after aortic valve replacement (AVR) for aortic regurgitation (AR) is associated with superior prognosis. The outcomes of valve-sparing aortic root replacement techniques on LV performance have not been compared with LV reverse remodeling in AVR. The present evaluation compared the extent of long-term LV reverse remodeling in patients with aortic root pathology and/or AR who underwent aortic valve repair (AVr) with patients who underwent AVR. MethodsA total of 226 patients (54.714.3 years, 63% male) with AR or aortic root pathology who underwent AVr (n=135) or AVR with the Freestyle (R) stentless aortic root bioprosthesis [Medtronic, Inc.; Minneapolis, Minnesota] (n=91) were included in the present retrospective evaluation. LV volumes and ejection fraction were assessed preoperatively, postoperatively (before hospital discharge) and during follow-up. ResultsBaseline characteristics were comparable between patient groups, except for higher prevalence of bicuspid aortic valve anatomy among AVR patients (38% vs. 16%, p<0.001). In addition, patients undergoing AVR had significantly larger LV end-diastolic and end-systolic volumes than their counterparts. After a median follow-up of 46 months (interquartile range: 17 to 78 months), both groups of patients showed a significant and sustained reduction in LV end-diastolic and end-systolic volumes, with significantly larger reduction in patients undergoing AVR. Ejection fraction decreased significantly postoperatively and improved later during follow-up similarly in both groups. The incidence of significant AR at long-term follow-up was comparable among groups (AVr: 8% vs. AVR: 7%). ConclusionsLV reverse remodeling occurs after AVR and AVr, reaching comparable LV volumes and function after a median of four years of follow-up. doi: 10.1111/jocs.12457 (J Card Surg 2015;30:13-19)
- 出版日期2015-1
