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Related Experiment Videos

Method of managing the small aortic annulus during valve replacement

R H Blank, D F Pupello, L N Bessone

    The Annals of Thoracic Surgery
    |October 1, 1976
    PubMed
    Summary

    Aortic valve replacement can be enhanced by enlarging the annulus, even with mitral valve involvement. This technique, using Dacron patches and porcine heterografts, proved safe and effective in 20 patients, with no deaths or mitral dysfunction.

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    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Valve Repair
    • Aortic Valve Replacement

    Background:

    • Aortic valve replacement (AVR) can be challenging when the aortic annulus requires enlargement.
    • Limited annular size may necessitate the use of smaller prosthetic valves, potentially affecting long-term outcomes.

    Purpose of the Study:

    • To evaluate the safety and efficacy of annular enlargement during AVR in patients requiring increased aortic root dimensions.
    • To assess the impact of this technique on mitral valve function post-operatively.

    Main Methods:

    • A retrospective review of 130 patients undergoing AVR.
    • Analysis of 20 patients who underwent ascending aorta enlargement using a Dacron patch.
    • Specific attention to 8 patients requiring annular division extending to the mitral valve anterior leaflet.

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  • Use of glutaraldehyde-fixed porcine heterografts for annular enlargement.

    • Main Results:

    • No mortality was observed in the group undergoing annular enlargement.
    • Successful implantation of larger prosthetic valves was achieved in all cases requiring annular enlargement.
    • Post-operative studies demonstrated no evidence of mitral valve dysfunction in any patient.

    Conclusions:

    • Annular enlargement, including division of the annulus extending to the mitral valve, is a safe and effective adjunct to AVR.
    • This technique facilitates the use of appropriately sized prosthetic valves without compromising mitral valve integrity.
    • Porcine heterografts are suitable for use in conjunction with annular enlargement procedures.