BEYOND THE PROSTHETIC VALVE: ONE-YEAR ECHOCARDIOGRAPHIC REVERSE REMODELING AFTER SURGICAL VALVE REPLACEMENT – A RETROSPECTIVE OBSERVATIONAL STUDY

Abstract

Background: Surgical valve replacement corrects valvular obstruction or regurgitation, but postoperative recovery also involves structural and functional adaptation of the cardiac chambers. This original study evaluated echocardiographic reverse remodeling beyond prosthetic valve performance. Methods: A retrospective observational study included seven patients with paired preoperative and postoperative echocardiographic records. Extracted parameters included aortic root diameter, left atrial diameter, left ventricular internal dimensions, interventricular septal and posterior wall measurements, ejection fraction (EF), fractional shortening (FS), valve Doppler velocities and gradients, and right ventricular systolic pressure (RVSP), where available. Changes were assessed descriptively at the individual-patient level; no inferential statistical testing was performed. Results: EF increased in all seven patients, with absolute improvements of 10–22 percentage points, while FS also increased in every case. Left atrial diameter decreased in all patients, with reductions ranging from 2.6 to 25.0 mm. Left ventricular internal dimension in diastole showed heterogeneous remodeling, decreasing in three patients and increasing in four. RVSP was available in three patients and decreased in all, from 69 to 35 mmHg, 45 to 35 mmHg, and 60 to 40 mmHg. Patient 1 demonstrated marked improvement in aortic haemodynamics, with Doppler velocity decreasing from 4.19 to 1.64 m/s and the recorded gradient from 70/41 to 11 mmHg.  Conclusion: Surgical valve replacement was associated with consistent improvement in systolic function and left atrial size, with favourable pulmonary pressure changes where measured. Ventricular dimensional remodeling was heterogeneous, highlighting the value of comprehensive echocardiographic follow-up beyond prosthetic valve assessment alone.