[Echocardiography in the evaluation and pre- and postoperative follow-up of chronic aortic insufficiency].

In chronic aortic regurgitation (CAoR) is difficult to determine the moment in which volume overload produces the myocardial deterioration which originates symptoms. We pretend to demonstrate the utility of echocardiography in defining the correct timing of operative correction in CAoR with pre- and post-operative comparison. Thirteen patients with CAoR (systolic ventricular-aortic gradient less than 20 mmHg) in whom the aortic valve was replaced were studied with an average of 13.7 months of follow-up. Two patients died immediately after surgery. Those remaining had a decrease in cardiomegaly grade and moved into functional class I. The echocardiogram revealed a significant reduction (P less than 0.01) in diameters of the left ventricle. The ejection fraction increased (P less than 0.05) in the post-operative period. Fractional shortening (FS) and mean velocity of circumferential shortening showed no significant change. The index end-systolic diameter over normalized velocity of the posterior wall IESD/NVPW) decreased considerably and the mean velocity of circumferential relaxation (Vcfr) increased (P less than 0.001) after surgical treatment. The preoperative ESD/NVPW index and Vcfr correlated well with the left ventricular end-diastolic pressure (r = 0.891 and r = -0.885, respectively). There was no difference in the course of those patients with diminished FS. The ESD/NVPW index and the Vcfr allowed a better evaluation of the residual volume, of the Frank-Starling law and of distensibility as an expression of the ventricular function. Consequently we conclude these indices are useful to establish the best moment for pre-operative catheterization in patients with CAoR.