Progress of surgical technique and anaesthesia enabled aortic valve replacement in the very elderly patients. However both valvular heart disease and ageing are associated with myocardial fibrosis. It is not known whether reverse remodelling and regression of hypertrophy, observed in the young patients after aortic valve surgery is possible also in the elderly. The aim of the study was to evaluate the changes of left ventricular structure and function in the elderly patients subjected to aortic valve replacement for aortic stenosis. Echocardiographic examinations were performed prior to surgery, approximately 4 weeks after the procedure and after an average of 32 months of follow-up. Left ventricular end-systolic (LVESV) and end-diastolic volumes (LVEDV) and ejection fraction (LVEF) were measured, as well as interventricular septum (IVSD) and posterior wall thickness (PWD). 43 patients over 74 years old (range 74-83), with aortic stenosis and transvalvular aortic gradient of 60-150 mmHg (mean 104 mm Hg), were included in the analysis. 17 patients received biological and 26 mechanical prosthesis. During the long term follow up LVEDV decreased from 143 ml to 114 ml, LVESV from 59 ml to 36 ml and EF increased from 59% to 68% (all p<0.05). Significant regression of left ventricular wall hypertrophy was observed (IVSD from 1.53 cm to 1.32 cm and PWD from 1.4 cm to 1.28 cm, all p<0.05).
In conclusion: the improvement of physical efficiency were observed. Favorable reverse remodelling of the left ventricle is observed also in elderly patients following valve replacement.