Comparison of Aortic Annulus Dimension After Aortic Valve Neocuspidization With Valve Replacement and Normal Valve

Abstract

Aortic valve replacement (AVR) remains the standard surgical intervention for aortic valve disease and is preferred by many surgeons, despite its associated clinical issues. The clinical efficacy of aortic valve neocuspidization (AVNeo) with glutaraldehyde-treated autologous pericardium, the Ozaki procedure, has recently been reported. Although it is presumed to preserve the normal aortic annulus motion, changes to the aortic annulus during the cardiac cycle after AVNeo remain unclear. From March to December 2014, aortic annular dimensions were measured for 23 patients; the sample included 8 patients who had undergone AVNeo, 10 patients with normal aortic valves, and 5 patients who had undergone AVR. Measurements were recorded using electrocardiography-gated multidetector computed tomography. Data were analyzed using automated aortic root analysis software. Postoperative peak pressure gradients for the AVNeo and AVR groups were compared. No statistically significant differences in annulus variation were observed between patients who had undergone AVNeo and those with normal aortic valves. Annular area was larger during systole than during diastole in both groups. Postoperative peak pressure gradients were significantly lower in the AVNeo group than in the AVR group. The results of the present study demonstrated that aortic annular dimensions after AVNeo are similar to the dimensions of normal aortic valves. This was evidenced using electrocardiography-gated multidetector computed tomography, previously reported as the most reliable method, to evaluate annulus motion during the cardiac cycle. Lower postoperative peak pressure gradients might underlie the observed changes. These advantages will help in rectifying AVR defects.