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(Circulation. 1968;37:II-110.)
© 1968 American Heart Association, Inc.

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Hemodynamic Studies One Year After Homograft Aortic Valve Replacement

J. WARD KENNEDY M.D.¹; R. D. TWISS M.D.¹; J. R. BLACKMON M.D.¹; K. ALVIN MERENDINO M.D., PH.D.¹

¹ From the Medical Service, Veterans Administration Hospital, and the Departments of Medicine and Surgery and the First Surgical Service of the University Hospital, University of Washington School of Medicine, Seattle, Washington.

Clinical and hemodynamic evaluation has been carried out one year after homograft aortic valve replacement in 15 patients. These studies have included an evaluation of pressure gradients across the aortic valve, supravalvular cineangiocardiography, and left atrial biplane angiocardiography for the measurement of left ventricular volume, left ventricular mass, and quantitation of aortic regurgitation. Eight patients had an excellent result, three patients a good result, and three patients a fair result. One patient had a poor result because of persistent, severe aortic regurgitation. A small systolic pressure gradient was present across the homograft valve in 2 of 13 patients. Significant aortic regurgitation, defined as more than 3 L/min, occurred in four patients.

Patients with aortic regurgitation preoperatively had reduction in LV volume in proportion to the reduction in regurgitation after surgery. Left ventricular mass diminished postoperatively in proportion to the reduction in stroke work, as determined from the pressure-volume diagram.