P877Left ventricular myocardial mechanics and mass regression evaluation in 4 months follow up in patients with mechanical and biological aortic valve replacement


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Abstract

Background: Aortic stenosis induces a chronic pressure overload of left ventricle (LV), leading to LV hypertrophy. It is still unclear if prosthesis type may influence early left ventricular mass regression and myocardial mechanics after aortic valve replacement (AVR).Purpose: To compare early changes of systolic LV longitudinal and rotational function and degree of LV mass (LVM) regression in patients with stented, stentless and mechanical prostheses 4 months after AVR.Methods: 60 patients:38 with biological (32 stented and 6 stentless) and 22 with mechanical AVR, underwent TTE at a mean of 4 months post surgery. Images were analysed offline for speckle tracking echocardiography (STE) analysis using dedicated workstation. LVM was estimated from Devereux formula. We used apical rotation as a simple and feasible index of LV twist.Results: There were no significant differences between the groups with mechanical and biological prostheses in term of postoperative LVM regression, prosthesis size, effective orifice area and patient-prosthesis mismatch. LVM regressed over 4 months in all subgroups. In addition we found no significant differences between the three groups (mechanical, biological stented and stentless) in longitudinal, circumferential and apical rotational LV deformation parameters. Results are presented in the table.Conclusions: Despite potential superior haemodynamics of stentless xenografts, compared to the stented and mechanical valve replacements we found no differences in the 2D strain analysis of LV systolic function and LVM regression 4 months after AVR.

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