Aortic root widening: “pro et contra”

Srimurugan, Balaji; Krishna, Neethu; Jose, Rajesh; Gopal, Krishna; Varma, Praveen Kerala

doi:10.1007/s12055-020-01125-6

Cited by 2 publications

(4 citation statements)

References 74 publications

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“…The intraoperative data highlighted increased bypass and cross-clamp times associated with AVR+ARE procedures, reinforcing the perception of added complexity and potential risk. These findings align with existing literature, which has reported extended operative times and heightened reluctance among surgeons to adopt ARE techniques due to the anticipated perioperative and postoperative challenges (20,25). The study, while presenting a compelling case for the utility of ARE in preventing PPM, acknowledges limitations including its singlecenter design and modest sample size.…”

Section: Discussionsupporting

confidence: 75%

“…Despite the prevalence of small aortic annulus conditions among the study population, the uptake of ARE procedures was limited, a trend that may be attributed to the surgical community's reservations stemming from concerns over technical difficulties, the risk of perioperative complications, and the debated significance of patient-prosthesis mismatch (PPM) (24). This hesitance persists despite evidence suggesting that ARE can mitigate the risk of PPM, a crucial consideration given the high frequency of small aortic annulus conditions encountered (25,26). The intraoperative data highlighted increased bypass and cross-clamp times associated with AVR+ARE procedures, reinforcing the perception of added complexity and potential risk.…”

Section: Discussionmentioning

confidence: 99%

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Frequency of Aortic Root Enlargement to Prevent PPM Patients Undergone Aortic Valve Replacement in Peshawar Institute of Cardiology

Nasir,

Iqbal,

Haseeb

et al. 2024

JHRR

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Background: Surgical aortic valve replacement (AVR) remains the gold standard for treating symptomatic aortic valve stenosis, aiming to alleviate left ventricular overload, relieve symptoms, and enhance survival. Aortic root enlargement (ARE) is a technique used alongside AVR to accommodate a properly sized prosthetic valve, particularly in patients with a small aortic annulus, to prevent patient-prosthesis mismatch (PPM) and improve clinical outcomes. Objective: This study aimed to evaluate the outcomes of AVR with or without ARE at the Peshawar Institute of Cardiology, focusing on the procedural efficacy, incidence of PPM, and short-term post-operative outcomes. Methods: A retrospective analysis was conducted on 76 patients who underwent AVR, with or without ARE, from December 2020 to March 2023. Data were collected on demographics, clinical manifestations, etiology, comorbidities, operative details, and post-operative outcomes. Statistical analyses included mean ± SD for quantitative variables and frequencies with percentages for qualitative variables, using SPSS 26.0 for data analysis. Results: The average age of patients was 37.53 ± 15.589 years, with a mean BMI of 24.9125 ± 5.07249. Among the procedures, 48.7% were AVR alone, 11.8% AVR with ARE, 10.5% AVR with coronary artery bypass grafting (CABG), and 28.9% AVR with mitral valve replacement (MVR). The mean bypass time for AVR+ARE was 189.3333 ± 77.83155 minutes, compared to 161.9254 ± 64.08737 minutes for other valvular surgeries. Post-operative hospital stay averaged 5.4444 ± 1.74005 days for AVR+ARE cases, against 6.52 ± 2.003 days for other surgeries. Conclusion: AVR with ARE is a feasible and effective strategy for patients with small aortic annuli, demonstrating satisfactory short-term outcomes and potential to reduce PPM. The study highlights the need for cardiac surgeons to gain proficiency in ARE techniques and calls for further research to evaluate long-term outcomes.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Frequency of Aortic Root Enlargement to Prevent PPM Patients Undergone Aortic Valve Replacement in Peshawar Institute of Cardiology

Nasir,

Iqbal,

Haseeb

et al. 2024

JHRR

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“…The Konno‐Rastan procedure is the procedure that causes the most expansion in aortic root expansion techniques 7 . It provides 40%–50% expansion in the aortic root 8 . However, the risk of complications is high.…”

Section: Discussionmentioning

confidence: 99%

“…7 It provides 40%-50% expansion in the aortic root. 8 However, the risk of complications is high. Septal artery injury, conduction system damage, and intercameral…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of recurrent subvalvular discrete membrane and left ventricular outflow tract stenosis in an adult patient with a history of congenital cardiac surgery

et al. 2023

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Left ventricular outflow stenosis can develop at the supravalvular, valvular, and subvalvular levels. Resection of strictures at the diffuse subvalvular level is very difficult.In such pathologies, Konno-Rastan procedure provides very successful solutions as an anterior aortoventriculoplasty method. In this article, we performed anterior aortaventriculoplasty surgical treatment for tunnel type left ventricular outflow tract stenosis, recurrent subvalvular discrete membrane, and aortic regurgitation in an adult patient with a history of partial atrioventricular septal defect repair and subvalvular discrete membrane resection operation in early childhood. The Konno-Rastan procedure, which we applied to the redo case, which is rarely used in adult patients and rarely seen in the literature, is shared.

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Aortic root widening: “pro et contra”

Cited by 2 publications

References 74 publications

Frequency of Aortic Root Enlargement to Prevent PPM Patients Undergone Aortic Valve Replacement in Peshawar Institute of Cardiology

Frequency of Aortic Root Enlargement to Prevent PPM Patients Undergone Aortic Valve Replacement in Peshawar Institute of Cardiology

Surgical treatment of recurrent subvalvular discrete membrane and left ventricular outflow tract stenosis in an adult patient with a history of congenital cardiac surgery

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