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The human heart is a complex organ with an intricate system of valves that regulate blood flow. There are two main types of valves: atrioventricular (AV) valves and semilunar valves.
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...

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Related Experiment Video

Updated: Nov 14, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

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Published on: May 21, 2017

A Y Incision and Rectangular Patch to Enlarge the Aortic Annulus by Three Valve Sizes.

Bo Yang¹, Aroma Naeem¹

¹Department of Cardiac Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan.

The Annals of Thoracic Surgery

|March 8, 2021

Summary

A novel Y incision technique successfully enlarged the aortic annulus for a fifth-time redo aortic valve replacement, enabling mechanical valve implantation without complications. This simple method effectively addresses aortic annulus undersizing in complex redo surgeries.

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Area of Science:

Cardiovascular Surgery
Cardiac Valve Repair and Replacement
Surgical Techniques

Background:

Redo aortic valve replacement (AVR) presents challenges, particularly when aortic annulus undersizing prevents the implantation of a suitable mechanical prosthesis.
Fifth-time redo AVR is exceptionally rare, increasing complexity and risk.

Observation:

A Y-shaped incision was utilized to access and enlarge the aortomitral curtain and aortic annulus.
A Hemashield patch was employed to augment the aortomitral curtain, increasing the aortic annulus diameter from 21 mm to 27 mm.

Findings:

The described technique facilitated the successful implantation of a mechanical aortic valve in a patient undergoing a fifth-time redo AVR.
The procedure was completed without blood transfusion or any perioperative complications.

Implications:

This Y-incision enlargement technique offers a simple and effective solution for aortic annulus undersizing in complex redo AVR cases.
The approach may improve outcomes and expand options for patients requiring multiple aortic valve interventions.