Effect of Aortic Valve Replacement on the Left Ventricle.A Ciné-angiographic Evaluation

Heart catheterization and quantitative left ventricular ciné-angiography data on thirty patients with aortic vlave disease were analyzed pre-operatively and 12 months after insertion of a Björk-Shiley tilting disc valve. The pre-operative and postoperative data were compared and also with a control group of 22 patients with no organic heart disease. According to the functional NYHA classification, 14 patients had improved, 14 were unchanged and 2 had deteriorated. Regurgitation had been totally corrected in 27 patients, and the high or moderate pressure gradient between the left ventricle and aorta had been reduced, but the valve itself caused a gradient of 5 to 35 mmHg. The pre-operatively abnormal pump function, hypertrophy, dilatation and impaired myocardial function had all become markedly more normal. The most obvious changes were an improvement in stroke work relative to end-diastolic volume and myocardial mass (p less than 0.001) and reductions in end-diastolic volume (p less than 0.001), pump power (p less than 0.001) and myocardial mass (p less than 0.001). Aortic valve replacement seems to be an appropriate procedure in cases where the left ventricular performance and haemodynamics are sufficiently disturbed.