Impact of Left Ventricular Mass Index on Early Outcomes After Aortic Valve Replacement with Sutureless Bioprosthetic Valve: A Comparison of Two Decades
Keywords: Aortic stenosis, left ventricular hypertrophy, heart valve prosthesis
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). Patients and Methods: Postoperative early outcomes of 60 high-risk patients with aortic valve stenosis after replacement with sutureless bioprosthetic valve were retrospectively analyzed. Patients were grouped into two depending on LVMI. Left ventricular (LV) mass was calculated using the Devereux formula and indexed to the body surface area. High LVMI was defined as LVMI > 134 g/m2 for males and LVMI > 100 g/m2 for females. Early outcomes of surgery were compared between the normal and high LVMI patient groups. Results: Preoperative patient characteristics were similar between the groups. Early mortality was 8.3%. There was no statistically significant difference between the groups with respect to postoperative early complication rates and mortality. LVMI decreased from 114.7 ± 13.7 g/m2 at baseline to 109 ± 32.2 g/m2 at follow-up in group I (p= 0.60) and from 192.5 ± 31.9 g/m2 at baseline to 117.9 ± 25.2 g/m2 in group II (p< 0.001). Conclusion: The impact of high LVMI on morbidity and mortality after AVR with sutureless bioprosthetic valve was not deleterious in patients with isolated AS. 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.