[Long-term follow-up of enlargement annulus aortic valve replacement in small aortic root].
OBJECTIVE
To investigate the long-term survival of patients after aortic valve replacement with enlarged annulus.


METHODS
From July 1988 to December 2001, the annulus was enlarged in 45 patients. The enlargement techniques included Manouguian's (39 patients), Nicks's (5) and konno's (1). Doppler echocardiography was performed in 43 patients one month after operation. Left ventricular outflow gradient was derived from continuous Doppler measurements of flow velocity, and effective orifice area was calculated by the continuity equation.


RESULTS
The operative mortality was 4.4% (2/45) in this group. One patient died of ventricular fibrillation and the other, lower output syndrome. All patients were followed up with a cumulative follow-up period of 6.2 years. Neither valve-related deaths nor valve-related complications occurred. 97.6% survivors (42/43) belonged to NYHA class I-II, and 2.4% (1/43), class III. No significant differences were observed in hemodynamic performance of differently sized prostheses for each valve type.


CONCLUSIONS
Patient-prosthesis mismatch with heart valve prostheses as demonstrated by the indexed effective orifice area can be avoided by use of Manouguian's annulus enlarging techniques. The hemodynamic performance of these aortic valve prostheses is satisfactory.
Wu
Hong-bin
HB
Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Hu
Sheng-shou
SS
Qi
Guo-qi
GQ
Song
Yun-hu
YH
Dong
Chao
C
D000293:Adolescent; D000328:Adult; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult