Maximum Exercise after Aortic Valve Replacement with Pulmonary Autograft

Abstract

Patients describe excellent exercise tolerance after aortic valve replacement with a pulmonary autograft (Ross procedure) but objective data regarding exercise ability has not been available. This report describes testing of maximum exercise performance at least one year after operation. Four athletic males underwent aortic valve replacement with a pulmonary autograft. Exercise to exhaustion was performed on a bicycle ergometer. Measurements of oxygen consumption and echocardiography were carried out. High levels of work energy were achieved (230 to 331 watts). Oxygen consumption increased from a range of 1.7 to 5.1 mL·kg⁻¹·min⁻¹ at rest to 33 to 45.1 mL·kg⁻¹·min⁻¹ at peak exercise. Pressure gradients over the left ventricular outflow tract were calculated by echocardiography as 10 to 14 mm Hg after maximum exercise. These data indicate that high levels of exercise and excellent hemodynamic performance can be achieved after the Ross procedure allowing unrestricted aerobic athletic activities.