David H. Harpole, MD, Stanley A. Gall, MD, Walter G. Wolfe, MD, J

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Presentation transcript:

Effects of Valve Replacement on Ventricular Mechanics in Mitral Regurgitation and Aortic Stenosis David H. Harpole, MD, Stanley A. Gall, MD, Walter G. Wolfe, MD, J. Scott Rankin, MD, Robert H. Jones, MD The Annals of Thoracic Surgery Volume 62, Issue 3, Pages 756-761 (August 1996) DOI: 10.1016/S0003-4975(96)00378-5 Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 1 (A) Mean ejection pressure demonstrated a significant increase in left ventricular (LV) afterload 10 minutes after mitral valve replacement in patients with mitral regurgitation (MR), whereas total ejection fraction was diminished. (B) Mean ejection pressure demonstrated a significant decrease in afterload after aortic valve replacement in patients with aortic stenosis (AS). Left ventricular ejection fraction improved after valve replacement. The Annals of Thoracic Surgery 1996 62, 756-761DOI: (10.1016/S0003-4975(96)00378-5) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 2 (A) Total cardiac output (CO), forward CO, and mechanical pump efficiency were all significantly affected by mitral valve replacement for mitral regurgitation (MR). (B) After aortic valve replacement for aortic stenosis (AS), mechanical pump efficiency was not affected because there was a proportional increase in both forward and total COs. (NS = not significant.) The Annals of Thoracic Surgery 1996 62, 756-761DOI: (10.1016/S0003-4975(96)00378-5) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions

Fig. 3 (A) New York Heart Association (NYHA) functional class before and 20 months after operation demonstrated significant improvement for the surviving patients in the mitral regurgitation (MR) group. There was an increase in left ventricular ejection fraction (LVEF) at follow-up and a normal exercise response. (B) New York Heart Association functional class before and 20 months after operation demonstrated significant improvement for the surviving patients in the aortic stenosis (AS) group. There was maintenance of a normal LVEF at follow-up and a nearly normal exercise response. (NS = not significant.) The Annals of Thoracic Surgery 1996 62, 756-761DOI: (10.1016/S0003-4975(96)00378-5) Copyright © 1996 The Society of Thoracic Surgeons Terms and Conditions