[Aortic replacement in patients with small aortic root--a modified Manouguian operation with a report in four cases]

Patch enlargement is used for aortic replacement in the cases of small aortic root. Four cases of modified Manouguian operation, a kind of patch enlargement, were presented. In this method, the splitting of aortic leaflet of mitral valve and the opening of left atrial roof were avoided. Combined with a tilting position, a No 21 artificial valve could be implanted. The method is simpler, especially in the cases of double valve replacement, in which there is no possibility to split the aortic leaflet of mitral valve. The author's experiences were introduced.