Abstract
Echocardiography (echo) has been used in the preoperative evaluation of patients with aortic stenosis. To assess its role as a postoperative index of left ventricular peak systolic pressure (LVSP) in surgically relieved LV outflow obstruction, 13 patients were evaluated by both echo and cardiac catheterization (cath). Average postoperative period was 37 months (range 10 to 122 mos.). Of several variables assessed including LV volumes,LV mass/volume ratio, posterior wall thickness/LV cavity size ratio (Ws/Ds), and mean wall thickness/LV cavity radius ratio (≥/r), only systolic wall thickness on echo correlated with LV pressure at cath (r=0.70, p=N.S.). No correlation was found between LVSP at cath and that predicted by echo using any of the published regression formulae that have been applied in the preoperative period (mean cath LVSP=139mm, range 100mm to 180mm; mean echo LVSP per Glanz, et.al.=173mm, range 113mm to 225mm; mean echo LVSP per Aziz, et.al=187mm, range 136mm to 241mm.). In 12 cases echo overestimated LVSP measured at cath and it predicted abnormal LVSP in 11 patients though at cath LV pressure was normal in 10 of these. Percentage fiber shortening was found to be more than 2 standard deviations above established normals in 9 patierts These data indicate that currently applied formulae, while of value for preoperative assessment of LV pressure, are not reliable for use in the postoperative period and raise questions concerning the reversibility of preoperative myocardial changes.
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Gewitz, M., Werner, J., Kleinman, C. et al. 113 THE ROLE OF ECHOCARDIOGRAPHY IN POSTOPERATIVE AORTIC STENOSIS. Pediatr Res 12 (Suppl 4), 382 (1978). https://doi.org/10.1203/00006450-197804001-00118
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DOI: https://doi.org/10.1203/00006450-197804001-00118