Left Ventricular Reverse Remodeling after Surgical Aortic Valve Replacement for Aortic Regurgitation—An Explorative Study

Author:

Arnold Zsuzsanna12ORCID,Elnekheli Alexander3,Geisler Daniela12,Aschacher Thomas12ORCID,Lenz Verena12,Winkler Bernhard123,Moidl Reinhard12,Grabenwöger Martin123

Affiliation:

1. Department of Cardiovascular Surgery, Clinic Floridsdorf, 1210 Vienna, Austria

2. Institute of Cardiovascular Research, Karl Landsteiner Society, 1210 Vienna, Austria

3. Medical Faculty, Sigmund Freud University, 1020 Vienna, Austria

Abstract

Background: The timing of treatment for chronic aortic valve regurgitation (AR), especially in asymptomatic patients, is gaining attention since less invasive strategies have become available. The aim of the present study was to evaluate left ventricular reverse remodeling after aortic valve replacement (AVR) for severe AR. Methods: Patients (n = 25) who underwent surgical AVR for severe AR with left ventricular ejection fraction (LVEF) less than 55% were included in this study. Preprocedural and follow-up clinical and echocardiographic measurements of LVEF and left ventricular (LV) diameters were retrospectively analyzed. Results: Mean LVEF increased significantly following surgical AVR (p < 0.0001). LV diameters showed a clear regression (p = 0.0088). Younger patients and those receiving a mechanical valve tended to have less improved LVEF on follow-up than patients over 60 years or the ones who were implanted with a biological prosthesis (p = 0.0239 and p = 0.069, respectively). Gender had no effect on the degree of LVEF improvement (p = 0.4908). Conclusions: We demonstrated significant LV reverse remodeling following AVR for AR. However, more data are needed on LV functional and geometrical improvement comparing the different types of valve prostheses to provide an optimal treatment strategy.

Publisher

MDPI AG

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