A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement

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Presentation transcript:

A critical review of hemodynamic changes and left ventricular remodeling after surgical aortic valve replacement and percutaneous aortic valve replacement Shin-Jae Kim, MD, Zainab Samad, MD, Gerald S. Bloomfield, MD, MPH, Pamela S. Douglas, MD American Heart Journal Volume 168, Issue 2, Pages 150-159.e7 (August 2014) DOI: 10.1016/j.ahj.2014.04.015 Copyright © 2014 Mosby, Inc. Terms and Conditions

Figure 1 Flow diagram of literature search and study selection. American Heart Journal 2014 168, 150-159.e7DOI: (10.1016/j.ahj.2014.04.015) Copyright © 2014 Mosby, Inc. Terms and Conditions

Figure 2 Changes in hemodynamic variables after SAVR or TAVR. A and B, show the mean peak pressure gradient and the mean fractional decrease of peak pressure gradient after intervention. C and D, show the mean of mean pressure gradient and the mean fractional decrease of mean pressure gradient after intervention. E, shows the fractional increase of (indexed) EOA after intervention. EOAIFr increase, fractional increase of (indexed) EOA; mean PGFr decrease, fractional decrease of mean pressure gradient; mean PGpost, postintervention mean pressure gradient; peak PGFr decrease, fractional decrease of peak pressure gradient; peak PGpost, postintervention peak pressure gradient. American Heart Journal 2014 168, 150-159.e7DOI: (10.1016/j.ahj.2014.04.015) Copyright © 2014 Mosby, Inc. Terms and Conditions

Figure 3 Changes in LVEF after SAVR or TAVR. A, Changes in LVEF after SAVR and TAVR according to the preoperative LVEF. In studies with preoperative (or preprocedural) LVEF >50%, the mean fractional changes of LVEF after SAVR and TAVR were 4% and 6%, respectively. In studies with preoperative (or preprocedural) LVEF ≤50%, the mean fractional changes of LVEF after SAVR and TAVR were 14% and 20%, respectively. B, The fractional decrease of LVEF after SAVR (□) and TAVR (▲) according to the duration of follow-up. American Heart Journal 2014 168, 150-159.e7DOI: (10.1016/j.ahj.2014.04.015) Copyright © 2014 Mosby, Inc. Terms and Conditions

Figure 4 Changes in LV mass after SAVR or TAVR. A, The fractional decrease of LV mass index (or LV mass) after SAVR and TAVR according to the duration of follow-up. The mean follow-up of LV mass index (or LV mass) was longer in mechanical SAVR (△) and bioprosthetic SAVR (□) compared with TAVR (▲). B, The fractional decreases of LV mass index (or LV mass) during immediately to 3, 6, and 12 months after SAVR and TAVR, respectively. American Heart Journal 2014 168, 150-159.e7DOI: (10.1016/j.ahj.2014.04.015) Copyright © 2014 Mosby, Inc. Terms and Conditions

Figure 5 Patient-prosthesis mismatch after SAVR or TAVR. A, The mean indexed EOA in studies showing no PPM or high indexed EOA after SAVR and that in studies regardless of the PPM after TAVR. B, The mean peak pressure in studies showing no PPM or high indexed EOA after SAVR and that after TAVR with CoreValve or Sapien regardless of the PPM. American Heart Journal 2014 168, 150-159.e7DOI: (10.1016/j.ahj.2014.04.015) Copyright © 2014 Mosby, Inc. Terms and Conditions