title: Functional results in aortic root enlargement.
abstract: BACKGROUND
  The hemodynamically efficient valves with effective orifice areas that are used in aortic valve replacement have been positively determined to affect postoperative exercise capacity. The aim of this study was to evaluate the functional effects of aortic root enlargement in the late postoperative period for patients with a small effective orifice area.
  
  
  METHODS
  Nineteen patients with a small effective orifice area were included in the study. The study group comprised 9 patients who underwent isolated aortic valve replacement with 23-mm St. Jude Medical prosthetic valves and posterior aortic root enlargement. The control group comprised 10 patients in whom 19-mm and 21-mm St. Jude Medical prosthetic valves were implanted without aortic root enlargement. The patients were evaluated in the late postoperative period with echocardiography and cardiopulmonary exercise testing.
  
  
  RESULTS
  The 2 groups were similar in anthropometric parameter values, follow-up periods, echocardiographic findings, and the gradients at the prosthetic aortic valve at rest; however, the anaerobic threshold, peak oxygen uptake, minute ventilation volume, and walk time were significantly higher in the study group ( P <.05).
  
  
  CONCLUSIONS
  The choice of aortic root enlargement for the implantation of a valve with a larger effective orifice area is preferred by most of the surgeons over the implantation of a valve with a smaller effective orifice area. The late postoperative functional capacity of the patient is significantly improved with root enlargement. Surgeons should be encouraged to perform root enlargement in patients with a small effective orifice area, and such surgery may even be performed routinely in these patients.
authors.affiliation: Department of Cardiovascular Surgery, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
authors.forename: Serap Aykut
authors.initials: SA
authors.lastname: Aka
authors.forename: Gökçen
authors.initials: G
authors.lastname: Orhan
authors.forename: Sennur
authors.initials: S
authors.lastname: Unal
authors.forename: Seden
authors.initials: S
authors.lastname: Celik
authors.forename: Sahin
authors.initials: S
authors.lastname: Senay
authors.forename: Murat
authors.initials: M
authors.lastname: Sargin
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Biçer
authors.forename: E Ergin
authors.initials: EE
authors.lastname: Eren
mesh_terms: D000328:Adult; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D017079:Exercise Tolerance; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D005082:Physical Exertion; D016896:Treatment Outcome