title: Two-directional aortic annular enlargement for aortic valve replacement in the small aortic annulus.
abstract: We have encountered 3 patients with a small aortic annulus for whom the conventional posterior enlargement alone was not extensive enough to implant an artificial valve of acceptable size. Therefore, we performed two-directional enlargement, which is a combination of posterior and anterior enlargement. First, the posterior enlargement was done, and then an additional aortotomy was made anteriorly and extended to the ventricular septum. The aortic annulus was enlarged by 68% after the two-directional enlargement. At a follow-up of 31 months, the patients' functional status was New York Heart Association class I.
authors.affiliation: Department of Cardiac Surgery, Kinki University School of Medicine, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Otaki
authors.forename: H
authors.initials: H
authors.lastname: Oku
authors.forename: S
authors.initials: S
authors.lastname: Nakamoto
authors.forename: H
authors.initials: H
authors.lastname: Kitayama
authors.forename: M
authors.initials: M
authors.lastname: Ueda
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery; D002648:Child; D005260:Female; D006350:Heart Valve Prosthesis / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D019736:Prostheses and Implants
chemical_list: D011093:Polyethylene Terephthalates