Figure 3

Demonstrating that, despite marked afterload mismatch in a 55YOWM with an LVEF 23% and LV mass of 251 g, surgical relief of afterload in a patient with demonstrated myocardial reserve (mean/peak gradients of 52 and 33 mmHg, respectively) can ensue with striking improvements in LVEF and LV mass (57%EF and 197 g at 6 months post-AVR) with minimal change by year 4 (LVEF 56% and LV mass 158 g). The initial improvements in morphometrics and volumetrics paralled marked improvements in the patients clinical response, again most evident within the first 6 months post-AVR.