Early and mid-term results of aortic valve replacement in patients with severe aortic regurgitation

Background

Aortic regurgitation (AR) represents pressure and volume overload resulting in left ventricular (LV) dysfunction. Poor LV function was shown to be reversible after aortic valve replacement (AVR) which is the only effective treatment. The surgical risk increases in the presence of LV dysfunction. The aim of this study was to determine effect of AVR on LV functions in severe AR.

Methods

Sixty patients were included with severe chronic AR with NYHA classes III and IV, diagnosed clinically and by imaging studies as transthoracic echocardiography (TTE) and cardiac catheterization. Patients were followed up postoperatively at regular intervals by TTE examination.

Results

TTE values at discharge and 6 months after AVR were compared with pre-operative findings. We found no significant statistical difference between LV functions pre-operatively and at discharge. However, there was statistical improvement in these functions at 6 months post-operatively compared to their values at discharge. ECHO findings of NYHA class III and IV at 6 months post-operatively showed evidence of improvement in LV functions of class III patients while those in class IV didn't show change or even some deterioration in the ECHO findings.

Conclusions

LV functions showed mild or no improvement in early follow-up while after 6 months it showed that patients in NYHA class III got benefits more than those in class IV.