Technical Modifications to the Y-Incision Aortic Annular Enlargement Technique

Aortic annular enlargement has become an essential component of contemporary aortic valve surgery, particularly in the context of patient-prosthesis mismatch. We describe several practical technical adaptations to a Y-incision-based annular enlargement approach, derived from our institutional experience. These modifications focus on patch material selection, suturing strategy, and external reinforcement, with the aim of simplifying execution and enhancing hemostatic reliability while preserving the conceptual framework of the technique.