The Annals of Thoracic Surgery, Vol 31, 409-413, Copyright © 1981 by The Society of Thoracic Surgeons
Radionuclide angiography in evaluation of left ventricular function following aortic valve replacement
JT Santinga, MM Kirsh, TJ Brady, J Thrall and B Pitt
Congestive heart failure in patients surviving aortic valve replacement has
been associated with a high late mortality. To determine whether myocardial
dysfunction in these patients occurred preoperatively, perioperatively, or
during the early postoperative period, 19 consecutive patients undergoing
aortic valve replacement using cardioplegia and hypothermia were studied by
multiple-gated cardiac blood pool imaging. The resting ejection fractions
for 8 patients with aortic stenosis did not show significant changes
following operation. The 11 patients with aortic insufficiency has resting
preoperative values of 58 +/- 15%, which fell to 38 +/- 18% immediately
postoperatively (p less than 0.01), with the late values being 51 +/- 16%.
Eight of 18 patients (44%) showed deterioration of regional wall motion
immediately after operation, which persisted in 3 during the late
evaluation. The occurrence of new perioperative regional wall motion
abnormalities and persistent perioperative depression in left ventricular
function in some patients suggest the need for further improvement in
myocardial protection during cardiopulmonary bypass for aortic valve
replacement.
