Influence of left ventricular wall thickening on myocardial injury in aortic valve replacement

We retrospectively examined the influence of left ventricular wall thickening on myocardial injury in aortic valve replacement. Thirty-five patients who underwent aortic valve replacement in our hospital between January 1995 and July 1997 were studied. We divided these patients into 3 groups: group N (left ventricular thickness (LVT) < or = 10 mm), group H (10 < LVT < or = 15 mm), and group S (LVT > 15 mm). All patients of group S had aortic stenosis. CK and CK-MB were significantly higher and the cardiac index was significantly lower in group S than in the other groups. Intra-aortic balloon pumping was required for 50% of patients in group S, and a total dose of catecholamine above 10 micrograms/kg/min was also required for 50% of patients in this group. In the other groups, these percentages were significantly lower. Myocardial protection and postoperative care were difficult for patients with severe left ventricular hypertrophy with LVT over 15 mm in this study. Left ventricular wall thickness was a more important factor in determining difficulty with intraoperative myocardial protection than was left ventricular mass.