Mass regression in aortic stenosis after valve replacement with small size pericardial bioprosthesis

Tasca, Giordano; Brunelli, Federico; Cirillo, Marco; Amaducci, Andrea; Mhagna, Zen; Troise, Giovanni; Quaini, Eugenio

doi:10.1016/s0003-4975(03)00823-3

Cited by 37 publications

(26 citation statements)

References 20 publications

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“…The Doppler-echocardiographic measurements were performed as previously described. 24,25 Briefly, the dimensions of the left ventricle (LV) were assessed with 2-dimensionally guided M-mode tracings, with the measurements being made according to the recommendations of the American Society of Echocardiography. Left ventricular mass (LVM) was calculated with the corrected American Society of Echocardiography formula.…”

Section: Doppler-echocardiographic Datamentioning

confidence: 99%

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Impact of Prosthesis-Patient Mismatch on Cardiac Events and Midterm Mortality After Aortic Valve Replacement in Patients With Pure Aortic Stenosis

Tasca

Mhagna²,

Perotti³

et al. 2006

Circulation

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199

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Background-Prosthesis-patient mismatch (PPM) occurs when the effective orifice area (EOA) of the prosthesis being implanted is too small in relation to body size, thus causing abnormally high transvalvular pressure gradients. The objective of this study was to examine the midterm impact of PPM on overall mortality and cardiac events after aortic valve replacement in patients with pure aortic stenosis. Methods and Results-The indexed EOA (EOAi) was estimated for each type and size of prosthesis being implanted in 315 consecutive patients with pure aortic stenosis. PPM was defined as an EOAi Յ0.80 cm 2 /m 2 and was correlated with overall mortality and cardiac events. PPM was present in 47% of patients. The 5-year overall survival and cardiac event-free survival were 82Ϯ3% and 75Ϯ4%, respectively, in patients with PPM compared with 93Ϯ3% and 87Ϯ4% in patients with no PPM (PՅ0.01). In multivariate analysis, PPM was associated with a 4.2-fold (95% CI, 1.6 to 11.3) increase in the risk of overall mortality and 3.2-fold (95% CI, 1.5 to 6.8) increase in the risk of cardiac events. The other independent risk factors were history of heart failure, NHYA class III-IV, severe left ventricular hypertrophy, and absence of normal sinus rhythm before operation. Conclusions-PPM is an independent predictor of cardiac events and midterm mortality in patients with pure aortic stenosis undergoing aortic valve replacement. As opposed to other risk factors, PPM may be avoided or its severity may be reduced with the use of a preventive strategy at the time of operation. (Circulation. 2006;113:570-576.)

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Section: Doppler-echocardiographic Datamentioning

confidence: 99%

“…The relative wall thickness was calculated as previously described. 24,25 The LV ejection fraction was determined by the Simpson method.…”

Section: Doppler-echocardiographic Datamentioning

confidence: 99%

Impact of Prosthesis-Patient Mismatch on Cardiac Events and Midterm Mortality After Aortic Valve Replacement in Patients With Pure Aortic Stenosis

Tasca

Mhagna²,

Perotti³

et al. 2006

Circulation

Self Cite

199

139

View full text Add to dashboard Cite

show abstract

“…An incomplete relief of the LVOT obstruction may sustain residual hypertrophy [2] as it has already been shown. For this very reason, in the past, the unsatisfactory performance of stented valves had prompted to adopt stentless bioprostheses to attain low valve gradients, although, in this regard, mixed results have been reported.…”

Section: Role Of Prosthesis Fluid Dynamicsmentioning

confidence: 64%

“…The group with "inappropriate" hypertrophy showed some degree of LV dysfunction having extent of LV mass that is virtually unrelated to the degree of AS [11]. Furthermore, other clinically recognizable patient-specific factors such hypertension, obesity and peripheral vascular disease, may influence the extent of pre-operative LV hypertrophy and its regression postoperatively [1][2][3][5][6][7].…”

Section: Preoperative and Operativementioning

confidence: 99%

“…In the setting of aortic stenosis (AS), LV hypertrophy develops to limit the increase of LV systolic wall stress. Aortic valve replacement (AVR), is expected to eliminate the LV burden, inducing regression of LV hypertrophy [1,2] and possibly LV mass normalization with an improvement of life expectancy and elimination of symptoms. Left ventricular mass normalization is the most difficult goal to achieve because of irreversible alterations often present in the myocardium [3][4][5] at time of operation, as well as the presence of associated patients and prosthesis factors [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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