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When replacing the aortic valve, a small aortic root can limit the size of the prosthetic valve that can be implanted. If the new valve is too small in relation to the patient's body, the heart must continue to work against increased resistance—a so-called patient-prosthesis mismatch, which is associated with poorer clinical outcomes.

A new surgical technique has now been developed at the Department of Cardiac and Thoracic Aortic Surgery at the Medical University of Vienna and University Hospital Vienna that allows the aortic root to be dilated in a relatively simple and minimally invasive manner. This enables significantly larger prosthetic valves to be implanted, improves blood flow and, at the same time, creates better conditions for future treatment options. The new method and initial clinical findings have been published in the cardiac surgery journal JTCVS Techniques.

The replacement of the diseased aortic valve is regarded as one of the success stories of cardiac surgery. It began in 1960 with the first valve implantations. Over the decades since then, many different mechanical and biological prosthetic valves have been developed and implanted. One problem has remained unchanged since the inception of surgical aortic valve replacement: the annulus required to anchor the prosthetic valve can restrict effective blood flow from the left ventricle into the aorta—particularly in patients with a small aortic root.

Today, this issue is becoming even more significant because the choice of the initial prosthetic valve must take into account not only the current operation but also the patient's entire lifelong treatment strategy.

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