OBJECTIVES: It is difficult to estimate the improvement in left ventricular (LV) function after aortic valve replacement (AVR). The present study aimed to evaluate whether energy loss (EL) can predict the postoperative LV function after AVR. METHODS: Nine patients who underwent AVR with a bioprosthetic valve were enrolled in the present study. Porcine prostheses were used in 5 patients and bovine pericardial prostheses were used in 4 patients. The aortic flow pattern was visualized and EL and cardiac output (CO) were measured using 4-dimensional flow magnetic resonance imaging from the LV to the descending aorta; the EL/CO ratio in the extracted area was calculated as total EL/CO ratio. RESULTS: With a porcine valve, a severe helical flow was observed in the ascending aorta during the holosystolic phase. In contrast, with a bovine pericardial valve, straight transvalvular aortic flow was observed in the early systolic phase and 2 large vortical flows occurred on both sides of the greater and lesser curvature of the ascending aorta after the mid-systolic period. The total EL/CO ratio was strongly correlated with LV ejection fraction improvement after AVR (r = 0.74, P = 0.02). CONCLUSIONS: The aortic flow pattern is different between the porcine valve and bovine pericardial valve. The total EL/CO ratio is a valuable tool for evaluating the postoperative LV ejection fraction improvement after AVR. Optimization of total EL/CO ratio would have potential to improve haemodynamic performances after AVR.
OBJECTIVES: It is difficult to estimate the improvement in left ventricular (LV) function after aortic valve replacement (AVR). The present study aimed to evaluate whether energy loss (EL) can predict the postoperative LV function after AVR. METHODS: Nine patients who underwent AVR with a bioprosthetic valve were enrolled in the present study. Porcine prostheses were used in 5 patients and bovine pericardial prostheses were used in 4 patients. The aortic flow pattern was visualized and EL and cardiac output (CO) were measured using 4-dimensional flow magnetic resonance imaging from the LV to the descending aorta; the EL/CO ratio in the extracted area was calculated as total EL/CO ratio. RESULTS: With a porcine valve, a severe helical flow was observed in the ascending aorta during the holosystolic phase. In contrast, with a bovine pericardial valve, straight transvalvular aortic flow was observed in the early systolic phase and 2 large vortical flows occurred on both sides of the greater and lesser curvature of the ascending aorta after the mid-systolic period. The total EL/CO ratio was strongly correlated with LV ejection fraction improvement after AVR (r = 0.74, P = 0.02). CONCLUSIONS: The aortic flow pattern is different between the porcine valve and bovine pericardial valve. The total EL/CO ratio is a valuable tool for evaluating the postoperative LV ejection fraction improvement after AVR. Optimization of total EL/CO ratio would have potential to improve haemodynamic performances after AVR.
Authors: Edouard Semaan; Michael Markl; S Chris Malaisrie; Alex Barker; Bradley Allen; Patrick McCarthy; James C Carr; Jeremy D Collins Journal: Eur J Cardiothorac Surg Date: 2013-12-06 Impact factor: 4.191
Authors: H M Connolly; J K Oh; T A Orszulak; S L Osborn; V L Roger; D O Hodge; K R Bailey; J B Seward; A J Tajik Journal: Circulation Date: 1997-05-20 Impact factor: 29.690
Authors: Helmut Baumgartner; Volkmar Falk; Jeroen J Bax; Michele De Bonis; Christian Hamm; Per Johan Holm; Bernard Iung; Patrizio Lancellotti; Emmanuel Lansac; Daniel Rodriguez Muñoz; Raphael Rosenhek; Johan Sjögren; Pilar Tornos Mas; Alec Vahanian; Thomas Walther; Olaf Wendler; Stephan Windecker; Jose Luis Zamorano Journal: Eur Heart J Date: 2017-09-21 Impact factor: 29.983
Authors: Claudia Blais; Jean G Dumesnil; Richard Baillot; Serge Simard; Daniel Doyle; Philippe Pibarot Journal: Circulation Date: 2003-08-11 Impact factor: 29.690
Authors: Martin Andreas; Stephanie Wallner; Kurt Ruetzler; Dominik Wiedemann; Marek Ehrlich; Georg Heinze; Thomas Binder; Anton Moritz; Michael J Hiesmayr; Alfred Kocher; Guenther Laufer Journal: Eur J Cardiothorac Surg Date: 2014-12-18 Impact factor: 4.191