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Mitral Stenosis I: Introduction

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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...

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Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...

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Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Noninvasive Determination of Vortex Formation Time Using Transesophageal Echocardiography During Cardiac Surgery

Published on: November 28, 2018

Left ventricular performance in aortic valve replacement.

Yoshihisa Tanoue¹, Taketoshi Maeda, Shinichiro Oda

¹Department of Cardiovascular Surgery, Kyushu University, Fukuoka 812-8582, Japan. tanoue@heart.med.kyushu-u.ac.jp

Interactive Cardiovascular and Thoracic Surgery

|May 16, 2009

Summary

Aortic valve replacement (AVR) impacts left ventricular (LV) performance differently based on the condition. While LV contractility and efficiency improve long-term post-AVR, early worsening of LV efficiency is noted in aortic regurgitation patients.

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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

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Published on: December 11, 2017

Area of Science:

Cardiovascular Surgery
Cardiac Physiology
Echocardiography

Background:

Aortic valve replacement (AVR) is a critical intervention for aortic valve disease.
Understanding mid-term left ventricular (LV) performance post-AVR is essential for patient management.
LV contractility, afterload, and efficiency are key indicators of cardiac function.

Purpose of the Study:

To analyze mid-term left ventricular (LV) performance after isolated aortic valve replacement (AVR).
To compare the effects of AVR on LV contractility and afterload in patients with aortic stenosis (AS) versus aortic regurgitation (AR).
To evaluate LV efficiency (ventriculoarterial coupling) at mid-term follow-up.

Main Methods:

Transthoracic echocardiography data from 263 patients (AS, AR, ASR groups) before, after, and 1 year post-AVR.
Calculation of LV contractility (end-systolic elastance: Ees) and afterload (effective arterial elastance: Ea).
Assessment of ventriculoarterial coupling (Ea/Ees) and stroke work to pressure-volume area ratio (SW/PVA).

Main Results:

LV contractility (Ees) and afterload (Ea) decreased post-AVR in the AS group, but increased in the AR group.
LV efficiency (Ea/Ees, SW/PVA) worsened early post-AVR in the AR group.
Overall, LV efficiency improved over the 1-year follow-up in all patient groups, demonstrating satisfactory mid-term outcomes.

Conclusions:

AVR exerts contrasting effects on LV contractility and afterload between AS and AR patients.
Mid-term LV contractility and efficiency post-AVR are generally excellent and satisfactory.
Early post-AVR LV efficiency decline in AR patients requires attention, despite long-term improvement.