Left ventricular mass regression after aortic valve replacement with CryoLife-O'Brien stentless aortic bioprosthesis

Background and aim of the study: Left ventricular (IV) hypertrophy has been shown adversely to affect IV function and late outcome after aortic valve replacement (AVR). The study aim was to assess the time course of IV mass r egression (LVMR) after AVR with a CryoLife-O'Brien stentless bioprosthesis, and to identify factors affecting late reduction of myocardial hypertrophy , Methods: In total, 113 patients (60 males, 73 females; mean age 70.9 +/- 6. 5 years) were studied by echocardiography preoperatively, at discharge, at six and 12 months postoperatively, and yearly thereafter. IV diameter and t hickness were measured using M-mode echocardiography; IV mass was calculate d using the Devereux formula and indexed by body surface area (BSA). Results: IV end-systolic diameter, end-diastolic diameter, septal thickness and wall thickness decreased significantly after surgery (p <0.001). IV ma ss index (LVMI) was reduced by 16.6, 13.6, 10.1, 3.1,3.3,1.7,2.6, and 1.8% at discharge and at 6 months and 1, 2, 3, 4, 5, and 6 years, respectively. Most LVMR occurred within the first year, with further (not significant) re ductions at later examinations. Male sex (p = 0.002), arterial blood pressu re greater than or equal to 150 mmHg (p <0.001), IV ejection fraction (LVEF ) less than or equal to 35% (p = 0.01), NYHA functional class greater than or equal to III (p = 0.01), atrial fibrillation (p <0.001), mean transvalvu lar gradient 40 mmHg (p = 0.001), and prevalent aortic incompetence (p <0.0 01) were factors influencing LVMR, independently of baseline effective orif ice area and prosthesis size. Conclusion: AVR with the CryoLife-O'Brien stentless prosthesis resulted in significant LVMR. These findings encourage the use of this bioprosthesis in appropriate patients.