According to surgeons at the Mayo clinic, if a valve repair or replacement procedure is done when the left ventricle has enlarged and/or if the ejection fraction is inadequate, the operation may not be able to improve the ejection fraction. The surgeon said, "the biggest problem I see is that the patient has waited too long."
It is true the insuffiency of the aorta valve reduces cardiac output as some of the blood back flows into the left ventricle rather than going into circulation, and the heart works harder to maintain a good supply of oxygenated blood to meet the demand. A valve repair that reduces the blood back flow will reduce the burden of the heart and more blood pumped into circulation wih each stroke. Cardiac output is increased with the same contractility of the heart wall prior to heart valve intervention (assuming hypokinesis for low EF). So increased blood flow may not improve the EF, but it cerainly has a positve effect by increasing the blood flow with same contractility strength.
If the heart's left ventricle was/is enlarged due to the harder work, this condition can sometimes be reversed when the burden to the heart is reduced. An enlarged left ventricle can reduced the EF if the heart's LV was/is dilated cardiomyopathy. Reverse remodeling can return the heart to normal functionality.
About 7 years ago, I had congested heart failure, an enlarged left ventricle, and EF below 29% (heart failure range) due to ischemia (blocked coronary vessels) that impared heart wall movement (hypokinesis). A stent and medication improved the blood flow to the heart musce deficit of good blood flow. That revitalized the heart cells at that location and the heart's contractility improved where currently my heart is normal size and normal EF.
Hope this helps. and thanks for the question. Take care.
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There has been alot written on a lot of sites about this but the answer in a nutshell is yes...he can improve his EF through meds and lifestyle changes...i have read alot of posts on different sites on this but the common denominator is the same...ask the doc what meds they are going to put him on and if they can give you a list of lifestyle changes you both need to make to increase his EF....good luck....