Surgical Method for Facilitation of Aortic Valve Replacement: Intraoperative Application of External Pressure for Increasing the Transverse Axis of Aortic Annulus

Şahin Bozok^1*, Mert Kestelli², Aykut Şahin³, Hakan Kara⁴, Tevfik Güneş⁵, Berkan Özpak¹, Gökhan Ilhan¹, Serdar Bayrak²

¹Department of Cardiovascular Surgery, Recep Tayyip Erdogan University Faculty of Medicine, Training and Research Hospital, Rize, Turkey.
²Department of Cardiovascular Surgery, Izmir Katip Celebi University Faculty of Medicine, Atatürk Training and Research Hospital, Izmir, Turkey.
³Department of Cardiovascular Surgery, Osmangazi University Faculty of Medicine, Eskisehir, Turkey.
⁴Department of Cardiovascular Surgery, Ada Hospital, Giresun, Turkey.
⁵Department of Cardiovascular Surgery, Pamukkale University Faculty of Medicine, Denizli, Turkey.

DOI: 10.4236/wjcs.2015.510017                

Abstract

Background: Surgical method was introduced for enhancement of prosthetic valve insertion and overcoming difficulties ensourcing from prosthesis-patient mismatch. Methods: Twenty-two patients that underwent aortic valve replacement between January 2005 and July 2009 were included in this prospective study. In these patients, the insertion of prosthesis larger than the annulus diameter was attempted after the application of an external pressure that increased the transverse axis diameter of the aortic annulus. The postoperative results and complications were assessed. Results: This surgical method was performed on 22 patients (16 males, 6 females, mean age: 52.2 ± 15.8 years) during the valve replacement. In 12 patients (55%), replacement of proper sized aortic valve compliant to their surface area was accomplished, while the insertion of a proper valve could not be achieved in 10 (45%) of the patients. No perioperative mortality or complications related to the procedure were reported. Conclusion: Increasing the transverse diameter of aortic valve may not only facilitate the insertion of a prosthetic valve but also aid in overcoming prosthesis-patient mismatch. Further studies on larger series are necessary to document the actual effectively and precise selection criteria for application of this method.

Keywords

Aortic Valve, Replacement, Prosthesis, Mismatch, Aortic Annulus

Conflicts of Interest

The authors declare no conflicts of interest.

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