Original method of posterior aortoplasty for aortic valve replacement in cases with narrow aortic ostium

  • V. V. Popov National M. M. Amosov Institute of Cardiovascular surgery, NAMS of Ukraine (Kyiv)
  • O. O. Bolshak National M. M. Amosov Institute of Cardiovascular surgery, NAMS of Ukraine (Kyiv)
Keywords: narrow aortic ostium, dilatation of the root and ascending aorta, aortic valve replacement, cardiopulmonary bypass


132 patients with isolated aortic valve disease with narrow aortic ostium who underwent surgery in the Institute from 1 May 2009 to 01 Jan 2019 are included in the study group. Among 132 patients, 6 died at the hospital stage (hospital mortality – 4.5%). There were no negative remarks to the surgical technique in any case. Changes in echo data during the hospital stay: systolic pressure gradient across the left ventricular outflow tract (LVOT) before operation was 105.1±11.5 mmHg, with 25.9±4.1 mmHg on the aortic prosthesis upon discharge. Reconstruction of the root and ascending aorta according to the proposed method in cases of aortic hypoplasia and aortic valve replacement (AVR) is highly effective intervention.

The purpose of this research is to study possibilities of a new approach to the reconstruction of the root and ascending aorta in AVR.


  1. R. Hopkins. “Aortic annuloplasty with aortic root reconstruction to prevent patient-prosrhesis mismatch” The Journal of Heart Valve Diseases 2006 vol 15 P.488-493.
  2. Konno S., Imai Y., Iida Y., et al. A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring // J. Thorac. Cardiovasc. Surg. – 1975. – vol. 70. – P. 909.
  3. Manouguian S., Seybold-Epting W. Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet: new operative technique // J. Thorac. Cardiovasc. Surg. – 1979. – vol. 78. – P. 402.
  4. Nicks R.T., Cartmill T., Bernstein L. Hypoplasia of the aortic root: the problem of aortic valve replacement // Thorax. – 1970. – vol. 25. – P. 339-346.
  5. Popov V, Bolshak O., Vakulenko K. Correction of narrow ostium of aorta during aortic valve replacement: choice of surgical method. Abstracts of the 67th International Congress of the European Society of Cardiovascular and Endovascular Surgery (ESCVS); April 12-14, 2018. Strasbourg, France. J Cardiovasc Surg. 2018;59(Suppl 2 to N 3):28.
  6. Tully PJ, Aty W, Rice GD, Bennetts JS, Knight JL, Baker RA. Aortic valve prosthesis-patient mismatch and long-term outcomes: 19-year single-center experience. Ann Thorac Surg 2013;96:844-50.
  7. Girerd N, Mathieu P, Dumesnil JG, et al. Impact of aortic stenosis severity and its interaction with prosthesis-patient mismatch on operative mortality following aortic valve replacement. J Heart Valve Dis 2012;21:158-67.
  8. Hong S, Yi G, Youn YN, Lee S, Yoo KJ, Chang BC. Effect of the prosthesis-patient mismatch on long-term clinical outcomes after isolated aortic valve replacement for aortic stenosis: a prospective observational study. J Thorac Cardiovasc Surg 2013;146:1098-104.
  9. Head SJ, Mokhles MM, Osnabrugge RL, et aL The impact of prosthesis-patient mismatch on long-term survival after aortic valve replacement: a systematic review and meta-analysis of 34 observational studies comprising 27 186 patients with 133 141 patient-years. Eur Heart J 2012;33:1518-29.
  10. Takagi H, Yamamoto H, Iwata K, Goto SN, Umemoto T. A meta-analysis of effects of prosthesis-patient mismatch after aortic valve replacement on late mortality. Int J Cardiol 2012;159:150-4.
  11. Chen J, Lin Y, Kang B, Wang Z. Indexed effective orifice area is a significant predictor of higher mid- and long-term mortality rates following aortic valve replacement in pa-tients with prosthesis-patient mismatch. Eur J Cardiothorac Surg 2014;45:234-40.
  12. Dayan V, Vignolo G, Soca G, Paganini JJ, Brusich D, Pibarot P. Predictors and outcomes of prosthesis-patient mismatch after aortic valve replacement. JACC Cardiovasc Imaging 2016;9:924-33.
  13. Mahjoub H, Mathieu P, Larose E, et al. Determinants of aortic bioprosthetic valve calcification assessed by multi-detector CT. Heart 2015;101:472-7.
  14. Capoulade R, Larose E, Mathieu P, et al. Visceral adiposity and left ventricular mass and function in patients with aortic stenosis: the PROGRESSA study. Can J Cardiol 2014;30: 1080-7.
  15. Dumesnil JG, Pibarot P. The problem of severe valve prosthesis-patient mismatch in aortic bioprostheses: near extinction? J Am Soc Echocardiogr 2014;27:598-600.
  16. Horvitz-Lennon M, Braun D, Normand SL. Challenges in the use of administrative data for heart failure services research. J Card Fail 2016;22:61-3.
How to Cite
Popov, V. V., & Bolshak, O. O. (2019). Original method of posterior aortoplasty for aortic valve replacement in cases with narrow aortic ostium. Ukrainian Journal of Cardiovascular Surgery, (1 (34), 24-26. https://doi.org/10.30702/ujcvs/19.35/05(024-026)