Right ventricular function after aortic valve replacement: a pilot study comparing surgical and transcatheter...

Area of Science:

• Cardiology
• Cardiac Surgery
• Echocardiography

Background:

• Standard echocardiographic measures show impaired right ventricular (RV) function after surgical aortic valve replacement (SAVR).
• Transcatheter aortic valve implantation (TAVI) has not shown similar impairments in RV function.

Purpose of the Study:

• To investigate changes in RV performance after SAVR versus TAVI using 3D echocardiography.
• To gain deeper insights into RV mechanics following different aortic valve replacement procedures.

Main Methods:

• Prospective, non-randomized study with two parallel groups.
• Echocardiographic evaluation of 20 patients undergoing SAVR and 20 patients undergoing TAVI.
• Measurements performed 1 week before and 5–7 days after the procedure.

Main Results:

• Tricuspid annular plane systolic excursion (longitudinal contraction) decreased significantly after SAVR but remained unchanged after TAVI.
• RV midcavity transverse diameter shortening (transverse contraction) increased post-SAVR, contrasting with no change after TAVI.
• RV ejection fraction, assessed by 3D echocardiography, was unchanged in both SAVR and TAVI groups.

Conclusions:

• SAVR is associated with decreased RV longitudinal contraction and increased transverse contraction.
• TAVI does not alter RV longitudinal or transverse contraction.
• Global RV systolic function, indicated by ejection fraction and stroke volume, is preserved after both SAVR and TAVI.