Abstract 14772: Aortic Valve Repair for Aortic Regurgitation or Aortic Root Pathology Induces Similar Mid-Term Left Ventricular Reverse Remodeling as Valve Replacement
Introduction: Left ventricular (LV) reverse remodeling after aortic valve replacement for aortic root pathology and aortic valve regurgitation has been described and is associated with superior prognosis. However, it remains unknown whether successful aortic valve repair may also induce LV reverse remodeling.
Objectives: The present evaluation investigated whether LV reverse remodeling occurs to the same extent in aortic valve repair compared to aortic valve replacement with stentless bio-prosthesis.
Methods: Adult patients with aortic regurgitation or aortic root pathology who underwent aortic valve repair (AVr) or aortic valve replacement with Freestyle® stentless bio prosthesis (AVR-F) between 1993 and 2013 were included in the present retrospective evaluation. LV dimensions and ejection fraction were assessed preoperatively, postoperative (before hospital discharge) and during follow-up.
Results: AVr was performed in 125 patients (54.5±13.5 years, 62% male, mean Euroscore II 4.7±6.4). AVR-F was performed in 84 patients (54.5±15.2 years, 64% male, mean Euroscore II 5.1±7.3). The median echocardiographic follow-up was 48 months. No differences in baseline characteristics were observed, except for the frequency of bicuspid aortic anatomy which was more prevalent among AVR-F patients (38.1% vs. 16.8%, p=0.001). Both groups of patients showed a sustained and significant reduction in LV end-diastolic diameter and end-systolic diameter (Figure). LVEF decreased directly postoperative and improved later during follow up.
Conclusions: In conclusion, left ventricular reverse remodeling occurs in patients who undergo aortic valve surgery for aortic regurgitation or aortic root pathology. The extent of remodeling is similar for both aortic valve repair and replacement with stentless bio-prosthesis.
- © 2013 by American Heart Association, Inc.