HEART LEFT VENTRICLE REMODELING IN PATIENTS AFTER IMPLANTATION OF AORTIC ALLOGRAFT

The study was aimed at learning the left ventricle remodeling in patients after aortic allograft implantation during the long-term follow-up. From February 2009 to July 2016 the aortic valve replacement with allografts was performed in 102 patients. Hemodynamic parameters of implanted allografts and left ventricle function were assessed for 7–10 days postoperatively and at long-term follow-up visits: in 3 and 6 months, 1, 2 and 3 years. Implanted aortic allografts are characterized by satisfactory hemodynamic parameters in early and late postoperative periods. The effective orifice area of implanted valves did not change in any of the implanted allografts during the period under study. At the same time, there was a significant reduction in the maximum speed across the aortic valve, resulting in suboptimal systolic and mean gradients in the early postoperative period, which declined to normal values from 3 months to 2 years postoperatively. 3 During the first 3 months after the aortic allograft implantation there was a statistically significant left ventricle remodeling, which led to a decrease in end-diastolic and end-systolic left ventricle sizes and volumes, as well as to the restoration of the left ventricle ejection fraction. During the same period there was a reduction in the left ventricle myocardium thickness both during systole and diastole. At the same time, there was a significant reduction in the thickness of the interventricular septum myocardium during diastole. The changes described were statistically significant during the following periods: from 6 months to 1 year and from 2 to 3 years postoperatively. Left ventricle remodeling resulted in a significant improvement in the patients’ quality of life up to 3 months postoperatively, assessed using a MLHFQ questionnaire. During the first 3 months after aortic allograft implantation, the left ventricle was remodeled, which resulted in a decrease in end-diastolic and end-systolic left ventricle sizes, as well as in an increase in the left ventricle contractility. The life quality of patients after allograft implantation significantly improves during the first 3 months. Aortic allografts in the aortic position generally resemble the functioning of the native aortic valve during early and long-term (3-years) follow-up. During first three months after aortic allograft implantation we observed the left ventricle remodeling, which led to a decrease in the left ventricle end-diastolic and end-systolic sizes, as well as to a decrease in the end-diastolic and end-systolic left ventricle volume, and to an increase in the left ventricle contractility. The quality of life in patients after aortic allograft implantation significantly improved during first three months postoperatively.

allografts, hemodynamic parameters, left ventricle remodeling

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