Changes in patterns of left ventricular hypertrophy after aortic valve replacement for aortic stenosis and regurgitation with St. Jude Medical cardiac valves

In this study, we analyzed the extent and pattern of regression of left ven tricular (LV) hypertrophy after aortic valve replacement in patients with a ortic stenosis (AS) and compared the results with those of another group of patients with aortic regurgitation (AR). Seventy patients who underwent is olated aortic valve replacement were divided into 2 groups. Group 1 was com prised of 29 patients who underwent aortic valve replacement for aortic ste nosis, and Group 2 of 41 patients who underwent aortic valve replacement fo r aortic regurgitation. A third group of 10 healthy subjects served as a he althy control group. Echocardiographic studies were done before the operati on and 5 years postoperatively. At follow-up, a significant reduction in th e left ventricular mass was found in both groups, but it remained significa ntly greater than in the healthy control group. The ratio of LV wall thickn ess to radius (th/r) in Group 1 decreased significantly, and at follow-up i t was within the normal value. In Group 2, the th/r ratio increased, and at follow-up it was within the normal value. After aortic valve replacement, the wall thickness remained significantly greater than normal for patients with AS, and the chamber radius remained significantly greater than normal for patients with AR. For these reasons, LV hypertrophy still existed in bo th groups at postoperative follow-up. The actuarial survival rate was 85.3% at 16 years for Group 1 and 83.4% at 18 years for Group 2. There was no si gnificant difference in the longterm survival rates between the 2 groups. A ctuarial free dom from valve-related events was 91.9% at 16 years for Group 1 and 82% at 18 years for Group 2. There was no significant difference in the valve-related event free curves between groups. After 5 years of follow -up, th/r reached normal for both groups, indicating remodeling of the LV g eometry after aortic valve replacement.