Comparative analysis of left ventricular hemodynamics and hypertrophy after aortic valve replacement with homografts or mechanical valves.
Makaleler > Tam Makale · 2000
Yazarlar: S Basarir, F Islamoglu, E Ozkisacik, Yüksel ATAY, M Boga, T Bakalim, Mustafa ÖZBARAN, A Telli
The Journal of heart valve disease, Uluslararası, 2000, cilt 9, ss 45-52
Özet
BACKGROUND AND AIM OF THE STUDY: The study aim was to examine comparatively the effects of prosthetic and homograft valves in the aortic position on ventricular hemodynamics and structure. METHODS: Hemodynamic evaluations were performed at rest and during exercise in 38 patients who had undergone aortic valve replacement (AVR) with either a homograft (n = 19) or prosthetic valve (19-23 mm; n = 19). Using echocardiographic, electrocardiographic and hematologic methods, the pressure gradient (PG); aortic valve area; diameters of left anterior wall, posterior wall (PW) and interventricular septum (IVS); ejection fraction (EF); left ventricular mass (LVM) and mass index (LVMI); electrocardiographic data of LV hypertrophy; hemoglobin; hematocrit and lactate dehydrogenase (LDH) levels were measured. RESULTS: LVM and LVMI decreased significantly after surgery in both groups (p<0.001), but the decrease was significantly greater in the homograft group (p<0.05). The IVS and PW diameters in the homograft group decreased significantly postoperatively (p<0.05); the inter-group difference was also significant (p<0.01). In the homograft group there was a significant improvement in EF (p<0.05), and the exercise PG was significantly less. Both groups showed improved LV hypertrophy and correlation between V1S >24 mm criteria and LVMI measurements. Postoperative LDH levels in the homograft group were significantly lower than preoperative levels (p<0.05); the intergroup difference was also significant (p<0.001). CONCLUSIONS: Our data suggest that homografts, as compared to mechanical prostheses, provide significantly better hemodynamics in the aortic position.