Effects of cardiac valve replacement on the left ventricular volume and cardiac systolic function of the patient with giant left ventricle / 医学研究生学报

ABSTRACT

Objective Giant left ventricle indicates severe or irreversible pathologic injury of the cadiocytes in the left ventricle.This study was to investigate the effects of cardiac valve replacement on the volume of the left ventricle and systolic function of the heart.Methods We retrospectively analyzed the clinical data about 41 cases of cardiac valve replacement for giant left ventricle (left ventricle end diastolic dimension LVEDD ≥ 70 mm and left ventricle end systolic dimension LVESD ≥ 50 mm).We compared the LVEDD,LVESD and left ventricular ejection fraction (LVEF) of the patients before and at 1 week,3 months and 1 year after operation.Results Compared with the baseline,LVEDD and LVESD were decreased significantly at 1 week,3 months and 1 year after operation in a timedependent manner (P＜0.01),while LVEF reduced at 1 week (P＜0.01),restored to the preoperative level at 3 months (P=0.10),and increased at 1 year postoperatively (P＜0.05).Based on the New York Heart Association (NYHA) functional classification,there were 16 cases of class Ⅱ,22 cases of class Ⅲ,1 case of class Ⅲ-Ⅳ,and 2 cases of class Ⅳ preoperatively.Follow-up was completed in 36 cases (87.8％),with a mean time of 50.03± 19.28 (12-95) months,during which 34 (94.4％) of the patients survived,including 24 cases of NYHA class Ⅰ and 10 cases of class Ⅱ,and 2 (5.6％) died,1 from chronic cardiac failure complicated by multiple organ failure and the other from liver cancer with systemic metastasis.Five (12.2％) of the cases were lost to follow up.Conclusion Cardiac valve replacement decreases the left ventricular volume of the patient with giant left ventricle in a time-dependent manner.The systolic function of the heart is reduced in the early postoperative period,which,however,may gradually improve with time and become better than the preoperative status.