Supraannular aortic root enlargement in patients with small aortic annulus: efficacy and safety.

BACKGROUND

To accommodate optimal sized aortic valve, our experiences with supraan-nular aortic root enlargement (SAE) in 20 patients with small aortic annulus have been described.

METHODS

From June 1981 to April 1996, aortic valve replacement with a St. Jude Medical (SJM) valve had been performed in 46 patients with aortic stenosis consecutively. After August 1993, we employed SAE in patients to insert 23 mm or larger aortic prostheses (SAE group, n = 20; control group, n = 26). Patients were followed-up for a period of 1.7 to 8.3 years.

RESULTS

There were no intra- or postoperative complications. The pressure gradient across the prosthesis was greater than 30 mmHg in 4 patients of the control group and in 1 patient of the SAE group. Only in nineteen patients (73%) of the control group, 23 mm or larger sized valves could be implanted by a conventional technique. By contrast, with SAE, 23 mm or larger sized SJM prostheses were possible to implant in 19 out of 20 patients (95%).

CONCLUSION

To avoid valve-patient mismatch, SAE of aortic root is safe and effective.