• Hong-bin Wu, Sheng-shou Hu, Guo-qi Qi, Yun-hu Song, and Chao Dong.
• Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
• Zhonghua Wai Ke Za Zhi. 2003 Apr 1;41(4):247-9.

ObjectiveTo investigate the long-term survival of patients after aortic valve replacement with enlarged annulus.MethodsFrom July 1988 to December 2001, the annulus was enlarged in 45 patients. The enlargement techniques included Manouguian's (39 patients), Nicks's (5) and konno's (1). Doppler echocardiography was performed in 43 patients one month after operation. Left ventricular outflow gradient was derived from continuous Doppler measurements of flow velocity, and effective orifice area was calculated by the continuity equation.ResultsThe operative mortality was 4.4% (2/45) in this group. One patient died of ventricular fibrillation and the other, lower output syndrome. All patients were followed up with a cumulative follow-up period of 6.2 years. Neither valve-related deaths nor valve-related complications occurred. 97.6% survivors (42/43) belonged to NYHA class I-II, and 2.4% (1/43), class III. No significant differences were observed in hemodynamic performance of differently sized prostheses for each valve type.ConclusionsPatient-prosthesis mismatch with heart valve prostheses as demonstrated by the indexed effective orifice area can be avoided by use of Manouguian's annulus enlarging techniques. The hemodynamic performance of these aortic valve prostheses is satisfactory.

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