Aortic root enlargement: Short‐term outcomes from a decade's worth of experience

Abstract

Background: Patient prosthesis mismatch is a real problem observed in patients receiving aortic valves too small for their body surface area. This situation is entirely preventable with the apt use of root augmentation procedures. This study aims to evaluate and analyze short-term outcomes in patients who have undergone root enlargement procedures.Methods: Fifty-five patients with ages ranging from 11 to 65 years (36.74 ± 13.27), who have undergone root enlargement procedures between January 2009 and January 2019 are recruited for this study. The group comprises 23 males (41.8%) and 32 females (58.2%). Admission and follow-up parameters recorded over a period of 1 year were used for analyzing outcomes. The mean iAVA (aortic valve area indexed to body surface area) of the group was 0.49 ± 0.06 cm 2 /m 2 .Results: There was a significant increase in the indexed aortic valve area after root enlargement surgery from 0.49 ± 0.06 to 1.09 ± 0.19 cm 2 /m 2 . The difference was statistically significant (p < .05). St Jude Masters bileaflet prosthesis resulted in the highest iEOA (1.29 ± 0.18 cm 2 /m 2 ). TTK Chitra monoleaflet valve was the most commonly used valve in 61.81% of the cohort. At 1 year follow-up, there was a progressive decrease in left ventricle (LV) mass Index and mean gradients resulting in progressive improvement in the New York Heart Association functional class among patients. Conclusion:In experienced hands, root enlargement procedures result in good curative outcomes for patients through effective LV regression and symptom resolution on a short-term basis.