ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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ORIGINAL RESEARCH ARTICLES |
The Effect Of Preoperative Left Ventricular Filling Patterns On Prognosis In Patients With Aortic Valve Replacement
Ahmet AKGÜL, MD,a Larry O. THOMPSON, MD,b Ülkü YILDIZ, MD,a Sebahattin GÖKSEL, MD,a Ümit KERVAN, MD,a Mustafa SOYLU, MD,c Oğuz TAŞDEMİR, MDa
Departments of aCardiovascular Surgery and cCardiology, Yüksek İhtisas Hospital, ANKARA
bDepartment of Emergency, Bunbury Regional Hospital, South West Health Campus, Bunbury, AUSTRALIA
Objective: Although many studies have been performed to evaluate the effects of a variety of heart valves on left ventricular function, the alterations in diastolic function seen in patients with preoperatively restrictive filling patterns after aortic valve replacement (AVR) with various mechanical, stented or stentless prosthesis have not been sufficiently examined. This study aimed to assess and compare the changes in diastolic function in such patients following AVR.
Material and Methods: In accordance with preoperative echocardiographic findings in patients of similar age groups and body size, 24 patients were selected as having restrictive filling patterns (i.e. deceleration time (DT)≤150 msec, iso-volumetric relaxation time (IVRT)<100 msec). The patients underwent AVR with either St. Jude Medical (SJM) (n= 8) or CarboMedics (CM) mechanical valves (n= 6), or Medtronic Freestyle® (MF) (n= 6) or CryoLife-O’Brien (CO) (n= 4) stentless bioprotheses. Another 24 patients were selected as a non-restrictive, physiologic group. The effect of valve replacement on diastolic parameters was evaluated preoperatively and postoperatively at discharge and after 4 and 8 weeks by comparing the parameters before and after valve replacement.
Results: Improvement in DT, IVRT and ejection fraction occurred in all patients with restrictive filling patterns irrespective of valve type. Although the difference between the various types was not statistically significant, left ventricular mass regression was higher in patients with mechanical valves.
Conclusion: Preoperatively determined restrictive patterns appear to convey more benefit than that derived by patients with preoperative non-restrictive filling patterns. A greater improvement is to be expected in more advanced disease states in patients following AVR.Keywords: Left ventricular, hypertrophy, aortic valve, heart valve prosthesisTurkiye Klinikleri J Med Sci 2006, 26:258-264
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