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Abstract

To evaluate left ventricular function during exercise after aortic annular enlargement 15 patients with either aortic (group I, n = 8) or aortomitral (group II, n = 7) annuloplasty for small aortic annuli and eight patients (group III) with standard valve replacement for aortic stenosis without small aortic annuli received gated cardiac pool imaging by technetium-99m-labelled red blood cells at rest and during exercise at a mean of 23 months after operation. Left ventricular ejection fraction, preload requitable stroke work and stroke power index (preload requitable stroke work/systolic ejection period) were measured. Compared with resting values, left ventricular performance and stroke work rate on exercise after aortic annular enlargements increased significantly, as did those after standard aortic valve replacement. These results suggest that aortic annular enlargement can be indicated for surgical treatment of valvular heart diseases associated with small aortic annuli.

Keywords

small aortic annulus valve-patient size mismatch aortic annular enlargement left ventricular function exercise radionuclide study

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References

Rahimtoola

. The problem of valve prosthesis-patient mismatch. Circulation 1978; 58: 20–4.

Kirklin

Barratt-Boyes

. Aortic valve disease - enlarging the small aortic root. In: Cardiac Surgery, 2nd edn, New York: Churchill Livingstone, 1993: 554–5.

Nicks

Cartmill

Bernstein

. Hypoplasia of the aortic root - the problem of aortic valve replacement. Thorax 1970; 25: 339–46.

Konno

Imai

Iida

Nakajima

Tatsuno

. A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring. J Thorac Cardiovasc Surg 1975; 70: 909–17.

Manouguian

Seybold-Epting

. Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet. New operative technique. J Thorac Cardiovasc Surg 1979; 78: 402–12.

Norman

Cooley

Hallman

Nihill

. Left ventricular apical-abdominal aortic conduits for left ventricular outflow tract obstructions. Clinical results in eleven patients with a special composite prosthesis. Circulation 1977; 56(Suppl. 2): 62–5.

Manouguian

Kirchhoff

. Patch enlargement of the aortic and mitral valve rings with aortic-mitral double-valve replacement. Ann Thorac Surg 1980; 30: 396–9.

Kitamura

Nagase

Kurosawa

Imai

Hashimoto

Koyanagi

. Comparative study of left ventricular function in double valve replacement with or without patch enlargement of aortic and mitral valve annulus. Kyobu Geka 1984; 37: 416 (Summary).

Pugliese

Bernabei

Santi

Pasque

Eufrate

. Posterior enlargement of the small annulus during valve replacement versus implantation of a small prosthesis. Ann Thorac Surg 1984; 38: 31–6.

10.

Hashimoto

Kitamura

Koyanagi

. Comparative study of long-term results following aortic valve replacement with or without aortic annular enlargement. J Cardiovasc Surg (Torino) 1987; 28(Suppl.): 89.

11.

Kitamura

Fukushima

Nakano

Comparative study of long-term results following isolated and combined aortic valve replacement with or without enlargement of aortic valve ring. 14-years follow-up studies on 68 patients with small aortic annuli. Nippon Kyobugeka Gakkai Zasshi 1987; 35: 2135 (Summary).

12.

Wortham

Tri

Bowen

. Hemodynamic evaluation of the St Jude Medical valve prosthesis in the small aortic annulus. J Thorac Cardiovasc Surg 1981; 81: 615–20.

13.

Schaff

Borkon

Hughes

Clinical and hemodynamic evaluation of the 19mm Bjork-Shiley aortic valve prosthesis. Ann Thorac Surg 1981; 32: 50–7.

14.

Bove

Marvasti

Ports

Rest and exercise hemodynamics following aortic valve replacement. A comparison between 19 and 21 mm lonescu-Shiley pericardial and Carpentier-Edwards porcine valves. J Thorac Cardiovasc Surg 1985; 90: 750–5.

Left Ventricular Function on Exercise after Surgical Treatment of Small Aortic Annuli

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