Left ventricular hypertrophy due to aortic bypass grafting with a long prosthesis.

Progressive left ventricular hypertrophy was observed following operations in which long bypasses were inserted from the ascending aorta to the abdominal aorta for aneurysm exclusion in cases of thoracic aortic aneurysm. This effect was not observed after operations in which there was grafting with a short prosthesis for abdominal aortic aneurysm, wrapping and trans-section of the dissecing aneurysm. Clinical and experimental studies of the hemodynamic aspects suggest that the left ventricular hypertrophy was caused by an increase in systolic blood pressure at the aortic root due to the low distensibility of the long graft, a decrease in the Windkessel effect by exclusion of the proximal aorta and energy loss by turbulence formation of the proximal anastomotic area. Therefore, the distensibility or compliance at the long prosthesis seems to be very important in cases with long grafts of the aorta.