Left ventricular muscle mass regression after aortic valve replacement

Implanting a valve that will reduce left ventricular mass is critical in ao rtic stenosis, Regression of left ventricular hypertrophy in 46 aortic valv e replacement (AVR) patients receiving a St. Jude Medical (SJM) valve was a ssessed by serial electrocardiographic and echocardiographic studies during the preoperative, immediate, and late postoperative periods. The patients were divided into three groups according to valve size; 19 mm group (n=9), 21 mm group (n=20), and 23+mm group (n=17), There was no surgical mortality . The NYHA functional class improved from an average of 2.2+/-0.8 preoperat ively to 1.3+/-0.5 postoperatively. Left ventricular muscle mass index (LVM I) regression failed to reach statistical significance in the 19 mm group, whereas in the other two groups a steady decrease in the LVMI occurred with follow up. ECG findings were less remarkable showing insignificant differe nces in voltage among the three groups (p=0.000). In conclusion, the curren t data suggest that the 19 mm SJM valve may not result in satisfactory left ventricular muscle mass regression despite adequate function, even in smal l patients. Therefore, additional procedures to accommodate a larger valve may be warranted in the aortic annulus smaller than 21 mm.