The Effect of Aortic Valve Replacement on Left Ventricular Function in Patients with Aortic Valvular Disease

Despite improved surgical techniques and survival in patients following aortic valve replacement for aortic stenosis and aortic insufficiency, the proper timing for surgery remains controversial. The incomplete reversibility of left ventricular dysfunction remains a concern, and postoperative improvement of left ventricular function is not consistently demonstrated. We studied 11 patients with aortic stenosis and nine patients with aortic insufficiency using angiographic and radioisotope assessment of left ventricular function preoperatively. Postoperative left ventricular function was assessed over nine to 13 months by radioisotope multiple-gated acquisition (MUGA) scan. All patients with impaired left ventricular function preoperatively showed slow but significant recovery toward a normal left ventricular ejection fraction by nine to 13 months postoperatively. Patients with aortic stenosis or aortic insufficiency and depressed left ventricular function can clearly obtain substantial, albeit delayed, improvement after valve replacement.