Successful aortic root enlargement procedure in low resource setting: Two rare cases

Area of Science:

• Cardiovascular Surgery
• Thoracic Surgery
• Cardiac Valve Surgery

Background:

• Small aortic root is an infrequent complication during surgical aortic valve replacement (SAVR).
• This occurs when the chosen prosthetic valve size is incongruent with the patient's native aortic root anatomy.

Purpose of the Study:

• To highlight the implications of patient-prosthesis mismatch in SAVR.
• To emphasize the importance of aortic root enlargement in specific cases.

Main Methods:

• Two cases of patient-prosthesis mismatch during SAVR were analyzed.
• Prosthesis size selection was guided by body surface area (BSA) and indexed effective orifice area (iEOA) calculations.
• Aortic root enlargement was performed when a small aortic root was identified.

Main Results:

• Both patients underwent successful aortic root enlargement.
• Outcomes differed significantly: one patient experienced mortality, while the other reported an improved quality of life.

Conclusions:

• Aortic root enlargement should be anticipated in SAVR, particularly in patients with small aortic roots.
• Preoperative planning must account for the possibility of aortic root enlargement to manage potential worst-case scenarios.