Complicated Aortic Root Enlargement in a Patient Who Underwent Aortic Valve Replacement

Abstract

For patients with a small aorta, surgeons may use techniques such as the Manouguian method in addition to aortic valve replacement (AVR) to prevent patient prosthetic mismatch. These methods have been shown to have good outcomes and few complications. However, in this case presentation, a rare complication occurred in a 47-year-old woman who underwent AVR plus Manouguian surgery. After the surgery, her echocardiography revealed iatrogenic supra-aortic stenosis. The diagnosis was confirmed with computed tomography angiography, and the patient underwent surgery again at the site of the stenosis. Fortunately, the surgery was successful, and the stenosis was completely resolved.

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

“…Etiologically, rheumatic heart disease emerged as the predominant cause, followed by degenerative and congenital origins, underscoring the varied etiological spectrum of aortic valve disease in this population. Notably, hypertension was the most frequent comorbidity, aligning with the established correlation between hypertension, aging, and the increased risk of cardiovascular events and mortality (23,24). 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).…”

“…Notably, hypertension was the most frequent comorbidity, aligning with the established correlation between hypertension, aging, and the increased risk of cardiovascular events and mortality (23,24). 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).…”