Author + information
- Received June 29, 1987
- Revision received September 16, 1987
- Accepted November 18, 1987
- Published online May 1, 1988.
- Kanji Kawachi, MD∗,a,b,
- Soichiro Kitamura, MD, FACCa,b,
- Choken Oyama, MDa,b,
- Hironori Kobayashi, MDa,b,
- Ryuichi Morita, MDa,b,
- Tsutomu Nishii, MDa,b and
- Yasunapu Kawashima, MDa,b
- ↵∗Address for reprints: Kanji Kawachi, MD. Department of Surgery, Division of Thoracic and Cardiovascular Surgery, Nara Medical College, 840 Shijo-cho, Kashihara, Nara, Japan 634.
In this study of the limits of reversibility of left ventricular function after aortic valve replacement for aortic regurgitation, measurements were made of pre- and postoperative coronary blood Row and left ventricular volumes. Eighteen patients who had undergone aortic valve replacement for pure aortic regurgitation using the Björk-Shiley valve or the Bicerval valve were restarted an average of 8 ± 3 months after surgery.
Postoperative left ventricular end-systolic and end-diastolic volumes returned to near normal values. The slight left ventricular wall thickening apparent before surgery remained unchanged after surgery and, consequently, left ventricular mass, though somewhat reduced, remained abnormally high. Ejection fraction, which was low preoperatively, returned to normal postoperatively. Total coronary sinus blood flow decreased after surgery, but coronary sinus blood flow per 100 g of left ventricular mass increased. This recovery of coronary flow per unit mass was believed to cause the improvement in left ventricular function.
A significant correlation was found between postoperative systolic function and preoperative left ventricular endsystolic and end-diastolic volumes, wall thickness and, especially, left ventricular mass, the latter indicating that, if preoperative left ventricular mass is <350 g/m2, postoperative improvement of systolic function is attainable. Another significant correlation was indicated by measurements of coronary sinus blood flow per 100 g of left ventricular mass. If this is >35 ml/min before surgery, a postoperative improvement in systolic function to within the normal range may be expected.
- Received June 29, 1987.
- Revision received September 16, 1987.
- Accepted November 18, 1987.