Background
We evaluated the effects of three implantation techniques (everting mattress, non-everting mattress, and simple interrupt techniques) for aortic valve replacement in severe aortic stenosis with small aortic annulus on left ventricular performance and function.
Methods
Eighty-five patients who underwent aortic valve replacement for severe aortic valve stenosis were retrospectively examined. Left ventricular mechanics (Ees, end-systolic elastance; Ea, effective arterial elastance and efficiency), left ventricular ejection fraction, effective orifice area index, peak aortic valve velocity, and the left ventricular mass index were measured before and up to 1 month after surgery. Two-way repeated measure analysis of variance was used to compare parameters among the three valve replacement techniques.
Results
Echocardiography after aortic valve replacement showed similar significant increases in the effective orifice area index (p < 0.001) and significant decreases in the peak aortic valve velocity (p < 0.001) and left ventricular mass index (p < 0.05) for each technique. With regard to left ventricular mechanics, Ees did not change significantly across the techniques (p = 0.80), and Ea decreased significantly and similarly in each group after surgery (p < 0.001). Consequently, left ventricular efficiency (Ea/Ees and the stroke work to pressure/volume area ratio) improved significantly (p < 0.001 and p < 0.001 respectively) and similarly after surgery in each group.
Conclusions
The three implantation techniques for aortic valve replacement gave equally satisfactory hemodynamic results and any would be reliable for patients with severe aortic valve stenosis and small aortic annuli.