Influence of aortic valve replacement in patients with critical aortic stenosis with pronounced calcification on processes of left ventricular remodeling

Abstract

The article presents the results of aortic valve replacement in patients with aortic stenosis complicated by severe calcification, in patients with a preserved and reduced fraction of left ventricular ejection, in 3 months after the operation. Analysis of the natural history of aortic stenosis showed that after the first symptoms of the disease within 2 years more than 50% of patients die. The main causes of death are coronary insufficiency and cardiac arrhythmia. The only radical treatment for aortic valve defect is surgical correction. There is a statistically significant reduction in the peak and average pressure gradient on the prosthesis aortic valve, which demonstrates the effectiveness of surgical correction of the defect. Reducing the pressure in the left ventricle resulted in decreasing the degree of mitral regurgitation, which did not exceed the first-second degree in both groups after 3 months. Thus, the results indicate more severe violations of structural-geometric and functional parameters of the left ventricle before surgery in patients of the first group compared with those of the second group, as well as fairly significant decrease in linear and volumetric parameters of left ventricle, reduction in left ventricular myocardial mass and left ventricular myocardial mass index, increasing ejection fraction 3 months after surgery. Patients with aortic stenosis complicated by severe calcification, show estimates of structural and geometric and functional parameters of left ventricular function, assessment of mitral valve regurgitation and the degree of the valve before and after surgery by transthoracic echocardiography. Dynamics of structural-geometric and functional parameters of the left ventricle in patients of both groups in 3 months after prosthesis aortic valve is characterized by a significant decrease of linear and volumetric parameters of left ventrical, left ventricular myocardial mass l, increase of left ventricular ejection fraction, decrease in the degree of regurgitation on mitral valve, which indicates the positive impact of operations on processes of reverse left ventricular remodeling.