A narrow aortic root complicates aortic valve replacement and requires special attention due to technical difficulties and potential complications.
Heightened caution advised for AVR in narrow aortic roots; Level 5 evidence leaves open need for larger studies.
Not infrequently, the replacement of the aortic valve is complicated by significant narrowing of the aortic root, particularly the segment between the valve annulus and the commissural attachments. This anatomical variation causes not only technical difficulties, but mortality¹,²and certain postoperative complications and, therefore, deserves special attention. In the past four years we have encountered the association of aortic valve disease and significantly small aortic root in 11 patients, requiring aortic valve replacement. The review of the records of these patients forms the basis for this report (Table 1). Materials and Results Of the 11 patients under consideration, four were men and seven were women. Their ages ranged from 23 to 64 years with a mean of 47 years. All patients had calcific aortic stenosis and two, in addition, had mitral valve disease requiring surgical intervention. The majority were in cardiac decompensation and of these, two were in intractable
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Hassan Najafi (1969) studied this question.
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