Mitral and aortic annular enlargement for insertion of adequate size prosthetic valves

Mitral and aortic valve rings were radically enlarged in a 70-year-old white female presenting with unusually tiny and severely stenotic rheumatic mitral and aortic valve disease. A common aorto-left atrial incision created by cutting across the two valves made it possible to implant adequate size St. Jude valves. The resulting defect in the roof of the left atrium and the aortic root were closed with a generous patch of polytetrafluoroethylene (PTFE). The center of the patch and the unattached segments of the two prostheses were incorporated with interrupted horizontal mattress sutures.