Patch aortoplasty for insertion of the porcine heterograft

The porcine heterograft has been shown to be a very satisfactory replacement for the diseased aortic valve. In certain cases, the advantage of a low thromboembolism rate without anticoagulation must be weighed against the suboptimal orifice size noted in the smallest heterografts. In using the largest replacement possible, the surgeon may encounter difficulty with closure of the aortotomy. Patch aortoplasty, as used in the 4 cases reported here, allows implantation of a larger heterograft. The technique is simple and adds little time to the operation. In selected cases, enlargement of the aortic root should result in better long-term hemodynamic performance.