Left ventricular function before and following aortic valve replacement.

Abstract

Twenty-four patients with aortic valve disease were studied before and 19+/-12 months following valve replacement with a well functioning prosthesis. Biplane left ventricular angiography and pressures were utilized to determine end-diastolic volume/m2 (EDV), end-systolic volume/m2 (ESV), ejection fraction (EF), left ventricular mass/m2 (LVM) and stroke work (SW). There were nine patients with aortic stenosis (AS), ten patients with combined stenosis and regurgitation (AS-AR), and five patients with aortic regurgitation (AR). Following surgery, patients with regurgitation preoperatively showed marked regression in EDV and ESV. All groups demonstrated regression in LVM. Fifteen patients with a normal EF preoperatively (65+/-11%) had no change after surgery; the nine patients with a low EF before surgery (38+/-8%) had a normal EF after surgery (60+/-16%). We conclude that left ventricular dilatation, hypertrophy, and reduced left ventricular pump function are largely reversible after successful aortic valve replacement.