[Serial changes in cardiovascular dimensions and left ventricular function after surgery of valvular heart disease: a...

Serial changes in cardiac function after surgery were studied in 84 patients with various valvular heart diseases using M-mode and two-dimensional echocardiography (2-DE). The results were as follows: 1. Serial postoperative changes in cardiac dimensions and left ventricular functions were well documented by M-mode and 2-DE. 2. The change in left ventricular function became most pronounced one month after surgery, and remained unchanged in many patients during the subsequent observation periods. 3. Open mitral commissurotomy (OMC) and mitral valve replacement (MVR) were compared as to their benefits for patients with isolated mitral stenosis (MS) accompanied by left ventricular dysfunction, and MVR proved superior to OMC in terms of magnitude of functional improvement. 4. (a) Ejection fraction (EF) in patients with left ventricular volume overload was overestimated due to the influence of increased preload. Accordingly, EF which tended to be depressed one month after surgery was judged to reflect altered loading conditions; it did not represent myocardial damage caused by valve replacement. (b) In patients who had MVR or aortic valve replacement (AVR) without postoperative heart failure, EF remained unchanged in the MVR group after a lapse of one month postoperatively, while it tended to improve in the AVR group. This difference was thought to be caused by changes in left ventricular systolic overload resulting from correction of regurgitation. (c) In patients with MR and postoperative heart failure, there was a tendency for EF to decrease after a lapse of one month postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)