Noninvasive evaluation of late left ventricular function after aortic valve replacement.

Late left ventricular function was evaluated noninvasively in 24 survivors of isolated aortic valve replacement. Radionuclide left ventriculography (RNLV) was used to determine left ventricular ejection fraction (LVEF) and left ventricular segmental wall motion. These studies were available from a group of 87 patients surviving for 30 days or more (3.4% operative mortality rate). They were studied at rest by RNLV from 10 months to 10 years (45 months mean) postoperatively. Patients with preoperative LVEFs below the laboratory normal of 0.62 had increased postoperative values, and patients with preoperative LVEFs above 0.62 had decreased postoperative values. Thus the total mean postoperative LVEF was 0.67 ± 0.10 (mean ± SD) from a preoperative mean of 0.56 ± 0.18, reflecting the convergence of the extremes toward an optimal high-normal postoperative value. No correlation between age, type of myocardial preservation, functional classification, total bypass time, aortic cross-clamp time, or associated coronary artery disease was demonstrated with regard to postoperative change in LVEF. Eleven patients had pure aortic regurgitation (AR), seven had predominant aortic stenosis (AS), and six had mixed (AS-AR) lesion. Patients with acute AR (n = 4) had significantly (p