Intra-arterial aortoinfundibuloplasty: hemodynamic and anatomical study of a new method for the enlargement of a small aortic annulus.
A new method for prosthetic valve replacement in a small aortic annulus is described. An anatomical examination showed that the intra-arterial approach via the main pulmonary artery made it feasible to incise the aortopulmonary septum at the middle point of both coronary ostia and also to relieve left ventricular outflow tract obstruction with a two-dimensional patch. The pressure study in three mongrel dogs demonstrated that 6-mm augmentation of the host aortic annulus with this procedure made no significant difference in the pressure gradient between the right ventricle and the main pulmonary artery before and after operation. The right ventricular end-diastolic pressure did not show any significant change with respect to hemodynamics. It is expected from these results that our procedure could be used for the treatment of various types of left ventricular outflow tract stenosis without affecting the hemodynamics and, especially, right ventricular function.
Katsumata
T
T
Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College.
Kurosawa
H
H
Koyanagi
H
H
D000818:Animals; D001021:Aortic Valve / Q000601:surgery*; D001794:Blood Pressure; D004285:Dogs; D006350:Heart Valve Prosthesis / Q000379:methods*; D006439:Hemodynamics; D011651:Pulmonary Artery / Q000503:physiopathology* / Q000601:surgery; D013318:Stroke Volume; D016278:Ventricular Function, Right