Aortic Valve Dynamics During Exercise After Valve Sparing Root Replacement Surgery
Aortic Valve Dynamics During Exercise After Valve Sparing Root Replacement Surgery
Aortic valve sparing operations are applied in patients with a non-calcified tricuspid or
 bicuspid aortic valve associated with a root aneurysm, in order to preserve the valve, and
 avoid new aortic dilatation by stabilizing the aortic valve anulus with a graft prosthesis.

 This results in a normal functioning aortic valve, with a low forward gradient across the
 left ventricular outflow tract.

 Little is known about how the repaired aortic valve behaves in conditions of controlled
 exercise, and how the gradients across the valve change during exercise.
In a cohort of patients operated on since 2000 with a valve sparing operation for aortic root
 aneurysm in the Department of Cardiac surgery of the University Hospital Ghent, Belgium, and
 with gradients at rest across the aortic valve of <20mmHg, a graded exercise test on a
 bicycle (stepwise increase of afterload) will be performed, and the gradient across the
 aortic valve will be monitored by transthoracic echocardiography at each exercise level.
 Patients with tricuspid and bicuspid valves will be compared. An age matched, unoperated, and
 asymptomatic control group with normal functioning tricuspid and bicuspid valves will be
 examined with the same exercise protocol.

 The purpose of the study is the description of the gradients across the aortic valve during
 exercise, and the discrimination of risk factors that may induce increased gradients.

 The hypothesis is that patients with bicuspid valves will demonstrate higher gradients than
 patients with tricuspid valves, in operated and unoperated individuals.
Inclusion Criteria:

 -  been operated with a valve sparing root procedure in the University Hospital Ghent,
 Belgium, since 2000

 -  being able to perform an exercise test on a reclining bicycle

 -  normal left ventricular function

 Exclusion Criteria:

 -  <18 years or >60 years of age

 -  peak gradient across the aortic valve at rest of >20mmHg

 -  decreased left ventricular function