Annular Enlargement: Can It Be Effective for Patients With a Small Left Ventricular Outflow Tract?

BackgroundWe investigated the differences in clinical and echocardiographic parameters between patients who underwent aortic valve replacement (AVR) with and without annular enlargement (AE), considering the impact of left ventricular outflow tract (LVOT) between the two groups.MethodsPatients undergoing AVR between January 1996 and July 2023 were retrospectively analyzed. The primary endpoint was the differential trend in echocardiographic parameters between AVR with and without AE, assessed using a mixed regression model. Secondary outcomes compared all-cause mortality and valve-related adverse events between groups. Propensity score-matched analysis was employed to mitigate baseline confounders.ResultsIn the entire cohort, 75 underwent AVR with AE, and 824 received AVR-only. After matching, 300 patients were included in the final analysis (75 vs 225). Larger-sized valves were implanted in the AE group (P