Early Outcome of Patients with Small Aortic Root Underwent Aortic Valve Replacement using NICKS Technique Retrospective Study

Authors

1 Cardiothoracic Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

2 General Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

Abstract

Background: Surgical aortic valve replacement (AVR) is a prevalent intervention for managing aortic valve disease. Aim and objectives: To investigate the early outcomes of patients with a small aortic root who had aortic valve replacement with the NICKS procedure at Al Azhar University Hospitals, focusing on morbidity and death. Patients and methods: This retrospective analysis involved 40 patients with a small aortic valve annulus who had aortic valve replacement at Al Azhar University Hospitals. Results: Fourteen individuals had mixed lesions of aortic stenosis and aortic regurgitation, whereas twenty-six patients presented with mainly aortic stenosis. The diameter of the aortic root annulus ranged from 17 to 19 mm. The average aortic cross-clamp duration was 70.32 (±15.92 SD) minutes, and the average cardiopulmonary bypass duration was 118.9 (±20.73 SD) minutes. Among the patients reviewed, 2 (5.13%) had bleeding, and 1 (2.5%) encountered challenges in weaning from bypass. Among the analyzed patients, there was 1 (2.5%) fatality attributed to challenging weaning off bypass, with an average ICU stay of 2 to 5 days and an average duration of mechanical ventilation ranging from 6 to 48 hours. Conclusion: Nick's approach is a viable and secure treatment for patients necessitating aortic valve replacement (AVR) with a diminutive aortic root, facilitating the insertion of bigger prostheses, reducing anticipated prosthesis-patient mismatch (PPM), and preserving aortic valve performance without elevating the risk of death or postoperative hemorrhage.

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