Aortic regurgitation: ventricular response after aortic valve replacement

This study was designed to evaluate the usefulness of the ratio of the preoperative regurgitant stroke volume to left ventricular end-diastolic volume (RSV/LVEDV) for assessing the left ventricular function preoperatively. In 26 patients with aortic regurgitation (AR), the percent decrease in LVEDV was compared with the preoperative RSV/LVEDV, ejection fraction (EF), LVEDV, left ventricular end-systolic volume (LVESV) or left ventricular end-diastolic pressure (LVEDP). There was a significant correlation between the percent decrease in LVEDV and RSV/LVEDV. Patients with RSV/LVEDV of more than 0.26 had a significantly smaller postoperative left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI), and a greater postoperative EF than patients with smaller RSV/LVEDV. All but one patient with RSI/LVEDVI larger than 0.0016 LVEDVI had normal postoperative LVEDVI. Based on these findings, it is concluded that the RSV/LVEDV is an useful indicator for preoperative evaluation of left ventricular functions in patients with AR. Surgical intervention for patients with AR should be recommended before the RSI/LVEDVI drops to less than 0.0016 LVEDVI, to expect good postoperative ventricular responses.