Ventricular performance assessed by 2-dimensional strain analysis after Ross operation versus aortic valve...

Area of Science:

• Cardiovascular Surgery
• Cardiac Imaging
• Ventricular Mechanics

Background:

• The Ross procedure is a common aortic valve replacement for young patients, but it carries risks of right ventricular (RV) impairment due to conduit implantation and myocardial dissection.
• Aortic valve reconstruction (AVr) presents an alternative that may mitigate these risks.

Purpose of the Study:

• To compare ventricular performance between patients who underwent the Ross procedure and those who had aortic valve reconstruction (AVr).
• To evaluate the long-term impact of these procedures on left ventricular (LV) and right ventricular (RV) function using echocardiography and strain analysis.

Main Methods:

• Utilized 2-dimensional (2D) echocardiography and longitudinal strain analysis to assess ventricular performance.
• Compared 19 patients post-Ross procedure and 19 patients post-AVr with 19 age-matched healthy controls.

Main Results:

• Both patient groups showed significantly increased left ventricular (LV) volumes compared to controls.
• The Ross group exhibited significantly elevated right ventricular (RV) volumes and reduced peak longitudinal RV strain compared to both the AVr group and controls.
• Reduced RV strain in the Ross group correlated with pulmonary substitute pressure gradients, suggesting RV dysfunction.

Conclusions:

• Patients may exhibit elevated LV volumes years after either the Ross procedure or AVr.
• The Ross procedure is associated with increased RV volumes and reduced RV longitudinal strain, indicating persistent RV systolic dysfunction.
• AVr may offer a superior alternative for preserving RV function compared to the Ross procedure.