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Updated: Jun 11, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Recovery of long-axis left ventricular function after aortic valve replacement in patients with severe aortic
Tjebbe W Galema1, Sing-Chien Yap, Osama I I Soliman
1Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, The Netherlands. t.w.galema@erasmusmc.nl
Background:
Patients with aortic stenosis (AS) should undergo aortic valve replacement (AVR) before irreversible LV dysfunction has developed. Assessment of long-axis left ventricular (LV) function may assist in proper timing of AVR.
Objectives:
To assess serial changes in long-axis LV function before and after AVR in patients with severe AS and preserved LV ejection fraction.
Methods:
The study comprised 27 consecutive patients (mean age 64.9 ± 11.7 years, 15 males) with symptomatic severe AS, scheduled for AVR. Seventeen subjects without known cardiac disease, matched for age, gender, LV ejection fraction and cardiovascular risk factors, served as a control group. Long-axis LV function assessment was done with tissue Doppler imaging at 3 weeks, 6 months, and 12 months after AVR.
Results:
Mean aortic valve area in the AS group was 0.70 ± 0.24 cm². Pre-AVR peak systolic mitral annular velocities were significantly lower compared to controls (6.7 ± 1.5 vs. 8.9 ± 2.0 cm/s, P < 0.05). Post-AVR peak systolic mitral annular velocities improved to 9.1 ± 2.9 at 3 weeks, 8.6 ± 2.7 at 6 months, and 8.1 ± 1.7 cm/s at 12 months (P < 0.05). Improvements were seen over the whole range of pre-AVR peak systolic mitral annular velocities. Patients with improved Sm after AVR (defined as ≥ 10% compared to baseline values) did not differ in baseline characteristics as compared to those who did not improve.
Conclusions:
In patients with severe AS and preserved LV ejection fraction, abnormal systolic mitral annular velocities improve after AVR, independent of the pre-AVR value.
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