Aortic Valve Replacement with Annular Enlargement for Congenital Aortic Valve Stenosis

Yuzo Katayama	Motohiko Goda	Shinichi Suzuki
Yukihisa Isomatsu	Norihisa Karube	Keiji Uchida
Kiyotaka Imoto and Munetaka Masuda

（Division of Cardiovascular Surgery, Department of Surgery, Yokohama City University School of Medicine, and Department of Cardiovascular Surgery, Medical Center, Yokohama City University, Yokohama, Japan）

Objective:To investigate the efficacy of aortic valve replacement with annular enlargement for congenital aortic valve stenosis. Methods:Eleven patients underwent aortic valve replacement with annular enlargement for congenital aortic valve stenosis in our institute between January 2002 and July 2012. The clinical status of these patients, including preoperative and postoperative echocardiography, was evaluated in this study. Results:The median age of the patients was 15.5 years（range:9-38 years). The patients had a mean body surface area of 1.48±0.3m2（range:1.00-1.92m2). Mechanical prostheses were used in all patients and the techniques of aortic annular enlargement were the Nick procedure in 4 patients, Manouguian procedure in 3（modified Manouguian in 2), Yamaguchi procedure in 2, and Konno procedure in 2. The average follow-up period was 32.1 months（range:1-117 months). There was neither operative death nor late death. The peak/mean pressure gradient of aortic valve improved from 77.9±31.7/46.6±18.0mmHg preoperatively to 27.9±7.7/14.8±4.7mmHg postoperatively and to 28.3±11.1/14.1±7.0mmHg at intermediate-term follow-up. The estimated left ventricular mass also improved from 206.8±93.4g preoperatively to 179.7±61.1g postoperatively and to 100.4±76.3g at intermediate-term follow-up, respectively. Conclusions:Our series shows the efficacy and safety of aortic valve replacement with annular enlargement for congenital aortic valve stenosis.　 Jpn. J. Cardiovasc. Surg. 43:37-42（2014）

Keywords：congenital heart disease;aortic valve surgery;aortic annular enlargement