[Electrocardiographic and radiographic course after aortic valve replacement]

On a series of 170 aortic valve replacement - 100 aortic stenoses (AS) and 70 aortic regurgitations (AR) - with an early post operative death rate of 5.3% and a late one of 8% (with a minimum follow up of 1 year and an average one of 25.4 months, two electrocardiographic and radiological checks could be done on 123 patients, 12 months on an average after the operation, and again for 116 patients, 21 months after the operation. After a year there was a significant and substantial decrease of the left ventricular hypertrophy (LVH) and a moderate one of the radiological heart area (HA). The decrease of LVH (Sokolow's index and AVL) tended to be more marked for the AS group and that of HA for the AR. At the second check no further significant change of LVH or HA was noted for either group, and the average HA of the patients remained high. The mean post-operative decrease of LVH and HA was all the greater as the pre-operative value was higher; but it was independent of the stage of heart failure and of the pre-operative hemodynamic data. There was no correlation demonstrated between the amplitude of post-operative variations of HA or LVH and the main operative stages (aortic clamping, ventricular fibrillation, coronary infusion). There was no significant difference between the mean values of LVH or HA of the survivors and those of the early post-operative deaths. The mean value of pre-operative HA was higher in the patients who were to die late than in the survivors, but the difference was not statistically significant after 25.4 months. The mean pre-operative values of HA and LVH did not influence the quality of the post-operative functional result.