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Updated: May 5, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
[Adapted scale for analysis of necessary septal myectomy in aortic valve replacement]
M A Fomin1, E P Evseev1, E V Balakin1
1Petrovsky National Research Centre of Surgery, Moscow, Russia.
Objective:
To develop the adapted scale for analysis of necessary septal myectomy (SME) in aortic valve replacement (AVR) for severe aortic stenosis.
Material And Methods:
A retrospective and prospective analysis included 180 patients with severe aortic stenosis and interventricular septal hypertrophy ≥1.5 cm who underwent surgery between 2012 and 2024. Age of patients was 64 (61; 67.3) years. There were 96 (53.3%) men and 84 (46.7%) women. Heart failure NYHA class III was observed in 98 patients (54.4%), class II in 54 (30.0%) patients. The AVR+SME group included 100 patients, and the AVR group included 80 patients. Both groups did not differ in preoperative clinical and echocardiography characteristics.
Results:
Logistic regression was performed to identify significant predictors. Multivariate analysis provided logistic function including 3 predictors: IVST / PWT, indexed LV myocardial mass and aortic annulus diameter. Regression model included significant factors obtained at the first stage of analysis. The obtained prognostic model was significant (p<0.01). Sensitivity was 77.0%, specificity - 83.8%. IVST/ PWT and indexed LV myocardial mass increase the probability of concomitant SME, while aortic annulus diameter has inverse relationship. The cut-off point for indexed LV myocardial mass is 167.5 g, for IVST/ PWT - 1.15, for aortic annulus diameter - 23.5 mm. Further analysis was performed by assigning a score to each predictor. The total score in two groups was determined. Thus, total score > 83.5 indicates advisability of SME in aortic valve replacement.
Conclusion:
The new scale for predicting the need for SME in AVR will improve postoperative results.
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