Aortic Valve Replacement
Conditions
Keywords
patients- prosthesis mismatching
Brief summary
Aortic valve disease is a progressive illness that varies from minor valve thickening lacking obstruction of blood stream to severe calcification and alteration of the valve leading to weakened leaflet motion. Aortic valve replacement is a usual operation but can be complicated by a small aortic annulus requiring the insertion of an aortic valve prosthesis. Prosthesis-patient discrepancy results in worse outcomes.
Detailed description
Prosthesis-patient discrepancy results in worse outcomes, including elevated left ventricular work, decreased left ventricular mass regression, and has also been linked with high mortality. Therefore, Aortic root posterior enlargement by autologous fixed pericardium to insert an Aortic valve prosthesis with size suitable to patient body surface area to avoid the previous worse outcome of patient prosthesis mismatch. In this study the investigators will try to identify the benefits of Aortic Root Enlargement in management of Small Aortic Annulus in Patients with severe valvular aortic stenosis
Interventions
Patients of sever aortic stenosis 1: increase the diameter of aortic anulus by prosthetic patch or pericardial patch. Patients of sever aortic stenosis 1:only conventional aortic valve prosthesis will be used
Sponsors
Study design
Intervention model description
Aortic Root Enlargement in Patients with aortic stenosis with Small Aortic Annulus
Eligibility
Inclusion criteria
* 17-75 years old * patients with sever aortic valve stenosis undergoing valve replacement surgery * informed consent has been obtained
Exclusion criteria
* Planned off-pump cardiac surgery * Patients required intra-aortic balloon pump * under 17 years of age
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Transthoracic echocardiographic measurement of transvalvular gradient across aortic valve prosthesis<25 mmHg | Baseline 6 weeks postoperative | Mild stenosis gradient 25 mmHg, Moderate stenosis gradient 25-40 mmHg, Sever stenosis gradient \>40 mmHg |