Geometric change in the aortic annulus after aortic root remodeling in Japanese patients

The progression of aortic root dilation after remodeling remains unclear. This study investigated the geometric changes in aortic root morphology during the mid- to long-term period after aortic root remodeling in Japanese patients.

Seventy-six patients underwent aortic root remodeling between August 1996 and January 2022. We compared the echocardiographic findings of the aortic root morphology in the preoperative, early postoperative, and most recent late postoperative periods. The postoperative clinical outcomes were also assessed.

The mean preoperative diameters of the aortic annulus, sinus of Valsalva, and sinotubular junction were 25.2 ± 2.8 mm, 50.0 ± 7.6 mm, and 42.7 ± 9.5 mm, respectively. The mean grade of aortic regurgitation was 2.9°. Postoperatively, all diameters decreased significantly. The aortic annulus measured 21.3 ± 2.4 mm early postoperatively and 22.0 ± 2.4 mm late postoperatively, without significant enlargement over time. Ten patients required reoperation during the follow-up period; however, no significant aortic annulus enlargement was observed.

Aortic root remodeling preserved the aortic root morphology without any late enlargement of the aortic annulus, even in reoperation cases.