Aortic Valve Replacement
Conditions
Keywords
aortic stenosis, aortic valve replacement, pericardium
Brief summary
In this prospective single-center study included 60 patients with a severe degenerative aortic stenosis and small aortic annulus (\<21 mm) who underwent standard AVR with stented bioprosthesis (group 1, n=30) and aortic valve reconstruction using autologus pericardium (Ozaki procedure) (group 2, n=30)
Detailed description
Aortic valve replacement (AVR) in patients with a small aortic annulus is a challenging problem. Implantation of a small aortic valve sometimes leads to high residual gradients, despite a normally functioning prosthesis. Patients with a small aortic annulus, especially those with a large body surface area, are at higher risk of prosthesis-patient mismatch, which is associated with worse clinical outcomes and decreased survival. The purpose of this study was to compare the hemodynamic performance among the 2 management strategies (standard AVR with stented bioprosthesis and Ozaki procedure) in the context of a small aortic annulus (\<21 mm)
Interventions
PROCEDUREaortic valve replacement
Standart AVR using stented stented bioprosthesis aortic valve reconstruction using autologus pericardium
Sponsors
The Federal Centre of Cardiovascular Surgery, Russia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
60 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* severe degenerative aortic valve stenosis
Exclusion criteria
* redo operation, infective endocarditis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Indexed effective orifice area, cm²/m² | 12 months after surgery | Assessment of aortic valve dimension |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| prosthesis-patient mismatch (PPM) | 12 months after surgery | Indicator of the effectiveness of aortic valve replacement |
| Peak pressure gradient, mm.Hg | 12 months after surgery | Indicator of the effectiveness of aortic valve replacement |
| Mean pressure gradient, mm.Hg | 12 months after surgery | Indicator of the effectiveness of aortic valve replacement |
| Effective orifice area, EOA, cm² | 12 months after surgery | Assessment of aortic valve dimension |
Other
| Measure | Time frame | Description |
|---|---|---|
| Myocardial mass index, g/m² | 12 months after surgery | Assessment of reverse remodeling of the left ventricle |
| Indexed aortic annulus diameter, mm/m² | 12 months after surgery | Description and comparison of groups patients |
| Age (years) | 12 months after surgery | Description and comparison of groups patients |
| Body mass index, kg/m² | 12 months after surgery | Description and comparison of groups patients |
| Body surface area, m² | 12 months after surgery | Description and comparison of groups patients |
| Aortic annulus diameter, mm | 12 months after surgery | Description and comparison of groups patients |
Countries
Russia
Outcome results
None listed