Regression of Left Ventricular Hypertrophy After Aortic Valve Replacement with Sorin Freedom Solo and St. Jude Regent Valves: a Comparative Study

Background: Aortic stenosis (AS) is the most common form of valvular disease in the elderly population, with degenerative calcified valves remaining the primary cause of this condition. Due to the progressive nature of the disease, a significant reduction in aortic valve area leads to increased left ventricular (LV) pressure overload, resulting in adaptive but ultimately maladaptive concentric hypertrophy and progressive myocardial remodeling. Objective: The main objectives of the study were to assess the regression of left ventricular (LV) hypertrophy, Methods: This retrospective study included 150 patients who underwent surgical aortic valve replacement (AVR) with the Sorin Freedom Solo (SFS) stentless bioprosthesis and the St. Jude Regent (STJ) mechanical valve. Patients were divided into three groups based on follow-up duration: six months, one year, and two years. changes in transvalvular gradient, perioperative outcomes, and survival rates. Results: The results showed a significant reduction in the transvalvular gradient for both valves (p < 0.0001), with a more pronounced decrease in patients with the SFS valve. The thickness of the interventricular septum (IVS) continuously decreased in SFS patients across all groups, whereas a significant reduction was observed only in Group 2 for STJ valves. Left ventricular ejection fraction (LVEF) showed a significantly greater increase in patients with the SFS valve (p < 0.024), particularly in Group 2. Overall mortality was 5.30% for STJ valves and 6.66% for SFS valves, with no statistically significant differences in Kaplan–Meier survival analysis (p > 0.05). Conclusion: The SFS valve demonstrated superior hemodynamic performance and more pronounced LV hypertrophy regression, making it a suitable option for high-risk patients. The STJ valve ensures stable long-term function and remains the preferred choice for younger patients with acceptable operative risk. These findings highlight the importance of a personalized approach in selecting valvular prostheses.