I.G. Lebid, A.O. Razinkina, Yu.I. Klymyshyn, N.M. Rudenko Features of exercise tolerance in adult patients after aortic valve replacement with pulmonary autograft

The aim – to assess exercise capacity of adult patients at late period after aortic valve (AV) replacement with pulmonary autograft (Ross procedure, RP).

Material and methods. Fourty six consecutive adult patients were divided into two groups: group A – 22 patients after RP (NYHA I – group A1, n=8; NYHA II–III – group A2, n=14), group B – 18 healthy adults. Assessment of exercise tolerance was performed using the six-minute walk test and our proposed method of determining the physical work capacity (PWC) in adults with сongenital heart disease. Quality of life was estimated by SF-36.

Results. Distance of six-minute walk test in group A was 429.55±22.22 m; group B – 593.33±7.58 m, Р<0,01. PWC170, PWC170/kg in group A2 (745.7±72.2 kgm/min; 12.0±0.8 kgm/min/kg), in group A1 (1035.0±82.6 kgm/min; 14.1±1.1 kgm/min/kg), were lower compared to group B (1041.4±82.5 kgm/min and 16.5±1,1 kgm/min/kg, Р<0,05, Р<0,01; resp). Maximal oxygen consumption (VO2max) in group A2 (2.5±0.1 l/min) was lower compared to group B (3.0±0.1 l/min, Р<0.05). Conclusions. Assessing exercise capacity should be carried out in all patients after the RP using the six-minute walk test and our proposed method of determining the PWC in adults with сongenital heart disease. Lower exercise capacity at late follow-up period in some patients after RP was characterized by significantly reduced PWC170, VO2max as a result of additional interventions before and after RP and right ventricular dysfunction with good left ventricle function.

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