Aortic Valve Replacement with Annular Enlargement for Congenital Aortic Valve Stenosis

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  • Katayama Yuzo
    Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine
  • Goda Motohiko
    Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine
  • Suzuki Shinichi
    Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine
  • Isomatsu Yukihisa
    Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine
  • Karube Norihisa
    Department of Cardiovascular Surgery, Medical Center, Yokohama City University
  • Uchida Keiji
    Department of Cardiovascular Surgery, Medical Center, Yokohama City University
  • Imoto Kiyotaka
    Department of Cardiovascular Surgery, Medical Center, Yokohama City University
  • Masuda Munetaka
    Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine

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Other Title
  • 先天性大動脈弁狭窄症に対する弁輪拡大術の治療成績

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Description

Objective : To investigate the efficacy of aortic valve replacement with annular enlargement for congenital aortic valve stenosis. Methods : Eleven patients underwent aortic valve replacement with annular enlargement for congenital aortic valve stenosis in our institute between January 2002 and July 2012. The clinical status of these patients, including preoperative and postoperative echocardiography, was evaluated in this study. Results : The median age of the patients was 15.5 years (range : 9-38 years). The patients had a mean body surface area of 1.48±0.3 m2 (range : 1.00-1.92 m2). Mechanical prostheses were used in all patients and the techniques of aortic annular enlargement were the Nick procedure in 4 patients, Manouguian procedure in 3 (modified Manouguian in 2), Yamaguchi procedure in 2, and Konno procedure in 2. The average follow-up period was 32.1 months (range : 1-117 months). There was neither operative death nor late death. The peak/mean pressure gradient of aortic valve improved from 77.9±31.7/46.6±18.0 mmHg preoperatively to 27.9±7.7/14.8±4.7 mmHg postoperatively and to 28.3±11.1/14.1±7.0 mmHg at intermediate-term follow-up. The estimated left ventricular mass also improved from 206.8±93.4 g preoperatively to 179.7±61.1 g postoperatively and to 100.4±76.3 g at intermediate-term follow-up, respectively. Conclusions : Our series shows the efficacy and safety of aortic valve replacement with annular enlargement for congenital aortic valve stenosis.

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