Midterm results of aortic root enlargement with AVR in patients with narrow aortic root and AS.
- Author:
Kwang Hoon PARK
1
;
Haneuloo KIM
;
Kang Joo CHUI
;
Yang Haeng LEE
;
Yun Ho HWANG
;
Kwang Hyun JO
Author Information
1. Department of Thoracic & Cardiovascular Surgery, Pusan Paik Hospital, College of Medicine, Inje University.
- Publication Type:Original Article
- Keywords:
Annuloplasty, aortic;
Aortic valve, stenosis;
Aortic valve, replacement
- MeSH:
Adult;
Aortic Valve;
Echocardiography;
Follow-Up Studies;
Humans;
Pathology;
Survival Rate;
Ventricular Function, Left
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2000;33(4):285-289
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: For AVR using conventional prosthetic valves in adult patients with a narrow aortic root, aortic root enlargement is necessary to reduce postoperative pressure gradient across the aortic valve (deltaP). An evaluation of early and mid-term results of aortic root enlargement with AVR and echocardiographic follow up of deltaP and left ventricular function was performed. METHOD: From Aug. 1991 to Feb. 1998, eighteen patients aged 17 to 59 years(mean, 38+/-12 years) underwent Manouguian procedure with AVR. Aortic annular circumstance was enlarged 10.0mm to 18.0mm(mean, 12.6+/-6.3mm). Eight patients(44.0%) had NYHA class III status before operation, and seven cases of them underwent concomitant MVR. Valve pathology was ASr in 6 cases, AS in 4 cases, nd ASr+MSr in 8 cases. Replaced valve size was 21mm in 8 cases and 23 mm in 10 cases, and St. Jude Medical mechanical valve was used in 10 cases and Carbomedics in 8 cases. RESULT: Follow-up duration was 6 to 57 months (mean, 26+/-18 months), and total follow-up was 287 patient-year. There were one hospital death and one late death, therefore, actuarial survival rate was 85.7% at 56 months. Peak deltaP wad decreased significantly at postoperative mid-term period as 13+/-5mmHg, compared with thepreoperative one (42+/-8mmHg) (p<0.01). LVM(gm/m(2)) was also diminished as 35.8%(115+/-36gm/m(2))at postoperative mid-term period, compared with preoperative one (179+/-56gm/m(2))(p<0.05). CONCLUSIONS: There were no specific complications related to the procedure. And we could have adequate enlargement of aortic annulus to suitable prosthetic valve that have no effect of patient-prosthese mismatch.
