Postoperative echocardiographic study of patients with symptomatic chronic aortic regurgitation.

Abstract

Aortic valve replacement was performed in 31 patients with symptomatic chronic aortic regurgitation. The patients ranged in age from 13 to 66 (mean = 39) years and included 29 men and 2 women. They were followed up for a mean of 47 months. Perioperatively, 2 patients (6.5%) died, and 2 (6.5%) received a permanent pacemaker for complete heart block. Thirty patients received an M-mode echocardiographic examination both before, and 6 to 11 days after, the operation. In this early postoperative period, the end-diastolic dimension (EDD) and left ventricular end-diastolic radius/posterior wall thickness ratio (R/Th) decreased in all patients. This decrease in EDD could be predicted by preoperative ejection fraction (EF), but not by end-systolic dimension (ESD) or R/Th ratio. The ESD regressed only in patients with preoperative EF greater than 50%, or ESD less than 55mm, or R/Th less than 3.8. During the long-term follow-up, one each had mild tissue valve degeneration, stroke, infective endocarditis, and severe myocardial failure, but none died. Eighteen patients had repeated M-mode echocardiographic studies. There was no further regression of EDD and R/Th, while ESD showed significant decrease. The EF and fractional shortening (FS) did not change. Clinically, the patients who survived the operation improved or remained unchanged postoperatively in a functional status. However, those who had preoperative EF greater than 50% or ESD less than 55mm had a better postoperative functional class (1.2 +/- 0.4 vs 1.9 +/- 1.0, p less than 0.05, 1.2 +/- 0.4 vs 2.0 +/- 1.1, p less than 0.05, respectively). Thus, patients with symptomatic chronic aortic regurgitation can often benefit from valve replacement.(ABSTRACT TRUNCATED AT 250 WORDS)