Journals / Koşuyolu Heart Journal / 2019 / Cilt: 22 - Sayı: 2

Impact of Left Ventricular Mass Index on Early Outcomes After Aortic Valve Replacement with Sutureless Bioprosthetic Valve: A Comparison of Two Decades

Sol Ventrikül Kitle İndeksinin Dikişsiz Biyoprotez Kapak ile Aort Kapak Replasmanı Sonrası Erken Dönem Sonuçlara Etkisi; İki On Yılın Karşılaştırılması

Pages
112–119
Publication Date
2019-08-15
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Significant reduction in LVMI at 6 months is encouraging for these high-risk patients with severe LV hypertrophy; however, long-term follow-up is required.

📌 3 Key Takeaways

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Objective & Hypothesis:<!-- /* Font Definitions */ @font-face {font-family:Times; panose-1:2 0 5 0 0 0 0 0 0 0; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:"MS 明朝"; mso-font-charset:78; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:1 134676480 16 0 131072 0;} @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:Cambria; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:-536870145 1073743103 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} /* Page Definitions */ @page {mso-footnote-numbering-restart:each-section;} @page WordSection1 {size:595.3pt 841.9pt; margin:36.0pt 36.0pt 36.0pt 36.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} --> Introduction: The objective of the present study was to elucidate whether high left ventricular mass index (LVMI) affects early outcomes after sutureless bioprosthetic aortic valve replacement (AVR) in aortic stenosis (AS).
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Key Findings & Data:Patients and Methods: Postoperative early outcomes of 60 high-risk patients with aortic valve stenosis after replacement with sutureless bioprosthetic valve were retrospectively analyzed.
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Conclusion & Impact:Significant reduction in LVMI at 6 months is encouraging for these high-risk patients with severe LV hypertrophy; however, long-term follow-up is required.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Aort kapak stenozu · sol ventrikül hipertrofisi · kalp kapak protezleri

Abstract

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Özet

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Cite This Article

ANTAL, A., KARADEMİR, B. Ç., DEDEMOĞLU, M., ÇELİK, E. C., TUNCER, M. A. (2019). Impact of Left Ventricular Mass Index on Early Outcomes After Aortic Valve Replacement with Sutureless Bioprosthetic Valve: A Comparison of Two Decades. Koşuyolu Heart Journal, Cilt: 22 - Sayı: 2, 112–119. https://ajindex.com/articles/63858

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References (13)

  1. Kupari M, Turto H, Lommi J. Left ventricular hypertrophy in aortic valve stenosis: preventive or promotive of systolic dysfunction and heart failure? Eur Hear J 2005;26:1790-6
  2. Thomson HL, O’Brien MF, Almeida AA, Tesar PJ, Davison MB, Burslefttov DJ. Hemodynamics and left ventricular mass regression: a comprasion of the stentless, stented and mechanical aorticvalve replacement. Eur J Cardiothorac Surg 1998;13:572-5
  3. Villa E, Troise G, Cirillo M, Brunelli F, Tomba MD, Mhagna Z, et al. Factors affecting left ventricular remodeling after valve replacement for aortic stenosis. An overview. Cardiovasc Ultrasound 2006;4:25
  4. Phan K, Tsai YC, Niranjan N, Bouchard D, Carrel TP, Dapunt OE, et al. Sutureless aortic valve replacement: a systematic review and meta-analysis. Ann Cardiothorac Surg 2015;4:100-11
  5. Shrestha M, Fischlein T, Meurisc B, Flamengc W, Carreld T, Madonnae F, et al. European multicentre experience with the sutureless Perceval valve: clinical and haemodynamic outcomes upto 5 years in over 700 patient. Eur J Cardiothorac Surg 2016;49:234-41
  6. Santarpino G, Pfeiffer S, Pollari F, Concistrè G, Vogt F, Fischlein T. Left ventricular mass regression after sutureless implantation of the Perceval S aortic valve bioprosthesis: preliminary results. Interactive Cardio Vasc and Thorac Surg 2014;18:38-42
  7. Devereux RB, Reichek N. Echocardiographic determination of left ventricular mass in man: anatomic validation of the method. Circulation 1977;55:613-8
  8. Levy D, Savage DD, Garrison RJ, Anderson KM, Kannel WB, Castelli WP. Echocardiographic criteria for left ventricular hypertrophy: the Framingham Heart Study. Am J Cardiol 1987;59:956-60
  9. Foppa M, Duncan BB, Rohde LEP. Echocardiography-based left ventricular mass estimation. How should we define hypertrophy? Cardiovascular Ultrasound 2005;3:17
  10. Gerdts E, Rossebo AB, Pedersen TR, Cioffi G, Lonnebakken MT, Cramariuc D, et al. Relation of left ventricular mass to prognosis in initially asymptomatic mild to moderate aortic valve stenosis. Circ Cardiovasc Imaging 2015;8:e003644
  11. Orsinelli DA, Aurigemma GP, Battista S, Krendel S, Gaasch WH. Left ventricular hypertrophy and mortality after aortic valve replacement for aortic stenosis. JACC 1993;22:1679-83
  12. Duncan AI, Lowe BS, Garcia MJ, Xu M, Gillinov AM, Mihaljevic T, et al. Influence of concentric left ventricular remodeling on early mortality after aortic valve replacement. Ann Thorac Surg 2008;85:2030-9
  13. Minamino-Muta E, Kato