BACKGROUND: Left ventricular outflow tract dynamic obstruction may develop after aortic valve replacement for aortic stenosis with a higher mortality and morbidity and may persist until left ventricular mass regression occurs. The aim of this study was to ascertain the effects of myectomy-myotomy on the left ventricular mass and mean wall thickness regression and on left ventricular mass normalization at least 1 year postoperatively. METHODS: A total of 162 patients including 71 with myectomy-myotomy (group I) and 91 without (group II) were studied at pre- and postoperative echocardiography. RESULTS: The relative left ventricular regression, after adjustment by ANCOVA analysis, was significantly greater in group I than in group II (-24.6 +/- 14.7 and -16.8 +/- 17.8%, p = 0.004) and the absolute mean wall thickness regression was greater in group I than in group II (-1.6 +/- 1.3 vs -1.1 +/- 1.6 mm, p = 0.019). Multivariable analysis showed myectomy-myotomy as an independent predictor of left ventricular mass regression. CONCLUSIONS: Myectomy-myotomy may improve left ventricular mass regression after aortic valve replacement for pure aortic stenosis.
BACKGROUND:Left ventricular outflow tract dynamic obstruction may develop after aortic valve replacement for aortic stenosis with a higher mortality and morbidity and may persist until left ventricular mass regression occurs. The aim of this study was to ascertain the effects of myectomy-myotomy on the left ventricular mass and mean wall thickness regression and on left ventricular mass normalization at least 1 year postoperatively. METHODS: A total of 162 patients including 71 with myectomy-myotomy (group I) and 91 without (group II) were studied at pre- and postoperative echocardiography. RESULTS: The relative left ventricular regression, after adjustment by ANCOVA analysis, was significantly greater in group I than in group II (-24.6 +/- 14.7 and -16.8 +/- 17.8%, p = 0.004) and the absolute mean wall thickness regression was greater in group I than in group II (-1.6 +/- 1.3 vs -1.1 +/- 1.6 mm, p = 0.019). Multivariable analysis showed myectomy-myotomy as an independent predictor of left ventricular mass regression. CONCLUSIONS: Myectomy-myotomy may improve left ventricular mass regression after aortic valve replacement for pure aortic stenosis.
Authors: Rajat Datta; Prashant Bharadwaj; Naveen Aggarwal; G Keshavamurthy; Prafull Sharma; Nitin Bajaj; Vijay Bohra; V S Guleria; Balbir Singh Journal: Med J Armed Forces India Date: 2022-02-01