Aortic Annulus Enlargement vs. Conventional Surgery in Patients with Small Aortic Annulus Undergoing Aortic Valve Replacement

pp. 30-34

Abstract

Background: The goal of aortic valve replacement for severe stenosis is to relieve symptoms and prevent the mortality associated with the disease. Appropriate prosthetic valve size must be selected for each patient according to body surface area to avoid patient-prosthesis mismatch.

Objective: The aim of this study was to evaluate transvalvular gradient reduction at one-year follow up in patients with small aortic annulus undergoing valve replacement with annular enlargement vs. conventional replacement surgery.

Methods: A retrospective cohort study was performed including patients with small aortic annulus undergoing valve replace ment from January 2011 to December 2015. Two groups were selected: Group AAE consisting of patients in whom aortic annular enlargement was necessary and Group RVA19 involving patients in whom a #19 mm prosthetic valve was conventionally implanted.

Results: Postoperative gradients (within the first 3 months and at one year) were significantly lower in the group with aortic annular enlargement. Median cardiopulmonary bypass time increased 14 minutes in Group AAE. Bioprostheses were used in most cases. There was no statistically significant difference in mortality between the groups.

Conclusion: Aortic annular enlargement improves postoperative, short-term and at one year follow-up transvalvular gradients.