Extended aortoplasty to relieve supravalvular aortic stenosis.
An extended aortoplasty was used to relieve severe supravalvular aortic stenosis in 5 patients whose preoperative left ventricular-aortic gradient ranged from 85 to 140 mm Hg (median, 120 mm Hg). The stenotic ring above the commissures was divided in two places by an inverted U incision extending into the right and noncoronary sinuses. A distal vertical incision in the ascending aorta converted this into an inverted Y. The ridge above the left coronary sinus was excised. The aortic incision was repaired with an inverted Y-shaped Dacron gusset. The postoperative gradient ranged from 0 to 30 mm Hg (median, 15 mm Hg). The extended aortoplasty provides excellent relief of supravalvular aortic stenosis and, in addition, restores the aortic root geometry to a much more anatomical configuration than is achieved with the simple patch technique.
Stewart
S
S
Division of Cardiothoracic Surgery, University of Rochester Medical Center, NY 14642.
Alexson
C
C
Manning
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001011:Aorta / Q000503:physiopathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011312:Pressure