Myectomy-myotomy associated with aortic valve replacement for aortic stenosis: effects on left ventricular mass regression
Tasca, G.; Amaducci, A.; Parrella, P.V.; Troise, G.; Dalla Tomba, M.; Magna, Z.; Quaini, E.
Italian Heart Journal Official Journal of the Italian Federation of Cardiology 4(12): 865-871
2003
ISSN/ISBN: 1129-471X PMID: 14976851 Document Number: 564646
Left ventricular outflow tract dynamic obstruction may develop after aortic valve replacement for aortic stenosis with a higher mortality and morbidity and may persist until left ventricular mass regression occurs. The aim of this study was to ascertain the effects of myectomy-myotomy on the left ventricular mass and mean wall thickness regression and on left ventricular mass normalization at least 1 year postoperatively. A total of 162 patients including 71 with myectomy-myotomy (group I) and 91 without (group II) were studied at pre- and postoperative echocardiography. The relative left ventricular regression, after adjustment by ANCOVA analysis, was significantly greater in group I than in group II (-24.6 +/- 14.7 and -16.8 +/- 17.8%, p = 0.004) and the absolute mean wall thickness regression was greater in group I than in group II (-1.6 +/- 1.3 vs -1.1 +/- 1.6 mm, p = 0.019). Multivariable analysis showed myectomy-myotomy as an independent predictor of left ventricular mass regression. Myectomy-myotomy may improve left ventricular mass regression after aortic valve replacement for pure aortic stenosis.