Zafar Tufail, Ahmed Shahbaz, Naseem Ahmad, Mumraiz S Naqshband, Waqas Sami, Saqib Shafi Sheikh, Abdul Waheed.
Does smaller Aortic Valve Prosthesis affect early left ventricular mass regression?.
Pak Postgrad Med J Jan ;18(1):2-6.

Objective: The objective of aortic valve replacement (AVR) in aortic stenosis (AS) is to reduce the pressure overload on the left ventricle allowing myocardial mass regression and remodeling. Despite the continued refinement in artificial valve design, the smaller valves may not provide comparable reduction in left ventricular mass following AVR for AS. The objective of our study was to determine early regression of left ventricle mass and its relation to different valve sizes. Methods: Study was conducted at the Cardiac Surgery Department, Punjab Institute of Cardiology, Lahore. Thirty-three consecutive patients from June 2006 to February 2007 with isolated aortic stenosis undergoing aortic valve replacement were included in the study. Patients were divided in two groups depending upon the size of the valve inserted. Patients in Group A had aortic valve of size 21 or less and patients in Group B had aortic valve of size 23 or more. All clinical and echocardiographic data was collected prospectively. Results: In group A mean preoperative left ventricle mass index (LVMI) was 161.31 ± 13.89 gms / m2, which regressed to 134.64 ± 17.74 gms / (LVMI regression 16.53 %, p-value =0.162). In group B, mean LVMI regressed from 197.53 ± 13.41 gms / m2 to 178.47 ± 12.90 gms / (LVMI regression 9.64 %, p-value =0.57). Degree of regression of LVMI in group A and B was 26.67 ± 17.25 gms / m2 and 19.05 ± 13.15 gms /m2 respectively (with a p-value =0.729). There was no statistically significant difference in the degree of left ventricle mass regression in both groups. Conclusion: Use of smaller bileaflet valves (size 21mm) does not affect remodeling of left ventricle at least in relatively small body surface area.

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