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European Heart Journal 1986 7(6):501-508;
Copyright © 1986 by the European Society of Cardiology.
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© 1986 The European Society of Cardiology

Haemodynamic and echocardiographic findings after aortoventriculoplasty*

J. VOGT, E. R. DEVIVIE*, J. KONCZ* and A. J. BEUREN

Department of Paediatric Cardiology, Georg-August-University Göttingen, F.R.G.
*Department of Thoracic and Cardiovascular Surgery, Georg-August-University Göttingen, F.R.G.

Received 15 August 1985; revised 20 January 1986; .

Address for Correspondence: Dr J. Vogt, Department of Pediatric Cardiology, University of Göttingen, Waidweg 33,3400 Göttingen, F.R.G.

Abstract

Aortoventriculoplasty (AVP) is an established operative procedure for the enlargement of different types of severe left ventricular outflow tract obstruction. Between 1974 and 1985 75 aortoventriculoplasties were carried out in 72 patients ranging from 5 to 34 years of age. Three patients had to be reoperated upon due to significant right ventricular outflow tract obstruction, outgrown prosthesis, and dissecting aortic aneurysm. There were 7 early deaths (mortality rate 9.3%) and one late death (1.3%) following A VP. Out of the last 55 patients only 2 died (3.6%). In contrast to the unsatisfactory haemodynamic results of previous conventional operations. AVP reduced the mean residual gradient at rest across the left ventricular outflow tract from 84 ± 23 mmHg (range 50–160 mmHg) to 12 ± 12 mmHg (range 0.65 mmHg). Except in 2 patients, no gradient increased more than 15 mmHg with isoproterenol.

In the cross-sectional echocardiogram, the left ventricular outflow tract was enlarged from 1.9 ± 0.42 to 3.1$0.39 cm after AVP, whereas the aortic annulus had been expanded from 2.4 ± 0.36 to 3.2±0.35 cm (n = 17). The mean length of the inner patch covering the septal incision measured 2.1 cm ± 0.4 cm (n = 37). Our recatheterization studies after AVP revealed equally good haemodynamic results in all types of left ventricular outflow tract obstruction which cannot be relieved by conventional surgery.

Key Words: Aortoventriculoplasty • left ventricular outflow tract obstructions • postoperative haemodynamic and echocardiographic studies


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