Key result
Aortic root enlargement during AVR does not increase hospital mortality compared to a small prosthesis.
Why the study?
The management of small aortic roots during aortic valve replacement poses a clinical dilemma between implanting smaller prostheses with patient-prosthesis mismatch or performing aortic root enlargement, with uncertain impact on surgical risk and short-term outcomes.
Does aortic root enlargement using a bovine pericardial patch increase surgical risk or improve hemodynamics compared to standard AVR in patients with small aortic roots?
Comparison
Aortic root enlargement using bovine pericardial patch vs small prosthesis (≤21 mm) implantation without enlargement
Design
Cohort study
Follow-up
Mean hospital stay 9.7 days
Authors
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Aortic root enlargement may be performed without raising hospital mortality; leaves open its comparative long-term benefit versus small prosthesis.
Cohort (n=896)
Does aortic root enlargement using a bovine pericardial patch increase surgical risk or improve hemodynamics compared to standard AVR in patients with small aortic roots?
Absolute Event Rate: 0.9% vs 0.6%
p-value: p=0.8
Aortic root enlargement during aortic valve replacement in patients with small aortic roots is safe, does not increase hospital mortality, and significantly improves postoperative hemodynamics by reducing patient-prosthesis mismatch.
Coutinho et al. (2011) conducted a cohort in Small aortic roots requiring aortic valve replacement (n=896). Aortic root enlargement (ARE) using a bovine pericardial patch vs. Small aortic roots (SAR) group receiving prosthesis size ≤21 mm was evaluated on Hospital mortality (p=0.8). Aortic root enlargement during aortic valve replacement did not significantly increase hospital mortality compared to implanting a small prosthesis (0.9% vs 0.6%, p=0.8).
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