JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2014, Vol. 52 ›› Issue (8): 43-46.doi: 10.6040/j.issn.1671-7554.0.2014.038

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Study of diameter of ascending aorta and prosthesis-patient mismatch after aortic valve replacement

CHEN Lei, ZOU Chengwei, ZHANG Haizhou, ZHU Xiaolong, HAN Bo   

  1. Department of Cardiac Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250012, Shandong, China
  • Received:2014-01-15 Revised:2014-06-10 Online:2014-08-10 Published:2014-08-10

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Abstract: Objective To investigate changes of diameter of ascending aorta and the prosthesis-patient mismatch (PPM) after aortic valve replacement. Methods A total of 42 patients with aortic valve disease and ascending aortic dilatation (ascending aorta diameter 3.5 cm~5.0 cm) treated in our hospital during Dec. 2006 to Dec. 2012 were selected (cases with Marfan syndrome and ascending aortic dissection were excluded). The subjects were divided into bicuspid aortic valve group (group Ⅰ, n=22) and tricuspid aortic valve group (group Ⅱ, n=20) according to the features of aortic valves. According to the different types of valves, the subjects were divided into the mechanical valve group (group Ⅲ, n=26), and bioprosthetic valve group (group Ⅳ, n=16). All cases underwent simple aortic valve replacement surgery under cardiopulmonary bypass, without dealing with the dilated ascending aorta. The diameter of ascending aorta was measured and the effective orifice area index (EOAI) was calculated. According to EOAI, PPM was divided into three categories: mild (EOAI>0.85 cm2/m2), moderate (0.652/m2), and severe (EOAI≤0.65 cm2/m2). Results The ascending aorta change rates in group Ⅰ were: patients with aortic stenosis (0.6±1.09) mm/year, patients with aortic stenosis and regurgitation (0.5±0.6) mm/year, patients with aortic regurgitation(0.3±0.8) mm/year; the ascending aorta change rates in group Ⅱ were: patients with aortic stenosis (-0.2±1.2) mm/year, patients with aortic stenosis and regurgitation (-0.2±0.9) mm/year, patients with aortic regurgitation (-0.1±0.6) mm/year. Moderate PPM accounted for 15.38% in group Ⅲ and 43.75% in group Ⅳ. Conclusion Aortic valve replacement surgery is not adequant for BAV patients with aortic dilatation of the ascending aorta (aortic diameter 3.5 cm~5.0 cm), because postoperatively the ascending aorta will dilate to a certain degree. PPM occurs more often after aortic valve replacement and is likely to affect patients with bioprosthetic valve.

Key words: Aortic valve disease, Ascending aorta dilatation, Aortic valve replacement, Prosthesis-patient mismatch

CLC Number: 

  • R654
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