Aortic valve reconstruction in patients with small aortic annulus
Aortic valve replacement using a prosthetic valve could lead to prosthesis-patient mismatch (PPM) in patients with small aortic annulus. Hoffman et al. reported the surgical outcomes in 632 patients who had small aortic annulus and revealed that PPM occurred in 45.1% to 92.8% of patients, and about 4.0% to 22.8% had severe PPM.20 There was no PPM observed in our study 12 months surgery in the group with small aortic annulus (Table 5). It was consistent with Sho A et al.’s study which reported no patients who underwent the Ozaki procedure had PPM condition.21 The Ozaki technique does not utilize artificial annulus, in addition, the cusps are sutured directly to the natural annulus, which prevented pannus formation in prosthetic valve and PPM condition after surgery.