title: Technique for reconstruction of the sinotubular junction.
abstract: Correct geometric relationships between the annulus and sinotubular junction during stentless valve implantation are critical to minimize the development of insufficiency. Some patients with aortic valve disease have dilatation of the sinotubular junction and are unable to have a stentless valve placed by standard techniques. We recently encountered such a patient and reconstructed the sinotubular junction by aortic crenation. Multiple interrupted plicating sutures were used to reduce the aorta from a diameter of 42 mm to 28 mm. This method allows tailoring of the aorta to appropriate size by varying the number of crenating sutures.
authors.affiliation: Division of Cardiovascular Surgery, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
authors.forename: G
authors.initials: G
authors.lastname: Bhatnagar
authors.forename: G T
authors.initials: GT
authors.lastname: Christakis
authors.forename: P M
authors.initials: PM
authors.lastname: Murphy
authors.forename: D
authors.initials: D
authors.lastname: Oxorn
authors.forename: B S
authors.initials: BS
authors.lastname: Goldman
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000473:pathology / Q000601:surgery*; D004108:Dilatation, Pathologic; D005260:Female; D006350:Heart Valve Prosthesis / Q000379:methods*; D006801:Humans; D013536:Suture Techniques