Aortic Annulus Enlargement In Patients With Small Aortic Root Analysis Of The Clinical Effect In The Short Term And Middle Term After Valve Implantation

ObjectiveTo investigate the clinical effect of the small aortic root in patients with small aortic valve after valve ring enlargement combined with ring valve implantation Materias and methodsIn retrospective analysis,23 cases of patients with small aortic annulus(SAA)who underwent interlobular flap(ATS.AP flap)were enrolled in our hospital from April to February in 2016,There were 7 males and 16 females;aged 22-57 years,mean age(42.5 ± 19.0)years old;height 154-179 cm,body surface area(1.64 ± 0.35)m2.There were 13 patients with rheumatic aortic stenosis,7 patients with aortic valve degeneration,and 3 patients with congenital aortic valve.The patients in the whole group were treated with the Nicks method(widened with or without the coronoid and the patch was widened).The aortic valve was enlarged and implanted.The posterior valve(ATS)The All patients were followed up for 3 months,6 months,12 months of outpatient or inpatient follow-up.The patients in the whole group had complete medical records data.The data of the patients were analyzed before and after the operation.The patients included the effective valve area index,the left ventricular ejection fraction,the mean transonic valve pressure,the interventricular septum thickness,Chamber wall thickness,left ventricular mass index and other information.Statistical analysis of the indicators.ResultsIntraoperative flap application test apparatus for aortic ring diameter measurement,the average diameter of the aortic annulus was(17.57±1.41)mm;Aortic sinus of average diameter(20.52±1.83)mm.After the disc ring spread again measurement,aortic ring diameter on average(21.74±1.51)mm;aortic sinus of the mean diameter(27.30±1.64)mm.The size of the valves implanted relatively laminoplasty increases 2-3 models before.There were no perioperative and in-hospital deaths in 23 patients.Follow-up results showed that all patients not present aortic leaf of weeks postoperative leakage and abnormal expansion of aortic patch area,no PPM phenomenon happens.Left ventricular ejection fraction after 3 months no significant improvement(p = 0.09),after 6 months,12 months were obviously improved(p < 0.05).Left ventricular mass index(bmi),left ventricular short axis,aortic valve open area effectively shorten rate index,average aortic cross valve pressure indexes compared with preoperative improved significantly(p < 0.05).ConclusionsThe small aortic root in patients with aortic annular enlargement and ring valve replacement therapy is safe and effective in patients with no postoperative prosthesis-patient mismatch phenomenon;postoperative follow-up near and mid-term clinical results is satisfactory,long-term effect should be further observed.