title: Complete aortic root replacement in patients with small aortic annulus.
abstract: BACKGROUND
  We evaluated the effectiveness of our surgical method using a modified self-assembled valved composite graft in patients with a narrow aortic annulus.
  
  
  METHODS
  Between August 2000 and May 2001, 10 consecutive patients with a narrow aortic annulus underwent replacement of the aortic valve and the ascending aorta using a valved composite graft with mechanical valve prosthesis. The indication for surgery was aneurysm of the ascending aorta (8 patients) and aortic dissection (2 patients). To avoid valve-patient mismatch, a modified self-assembled valved composite graft was used.
  
  
  RESULTS
  There was no hospital mortality. Echocardiographic evaluation before discharge showed excellent hemodynamics with a mean transvalvular gradient of 10.7 mm Hg (standard deviation +/- 2.8 mm Hg).
  
  
  CONCLUSIONS
  The described valved composite graft offers very good hemodynamic performance and is a simple and effective device to avoid valve-patient mismatch in patients with a small aortic annulus who need aortic root replacement.
authors.affiliation: Herz- und Gefaess-Klinik, Bad Neustadt, Germany. urbanski@kardiochirurg.de
authors.forename: Paul P
authors.initials: PP
authors.lastname: Urbanski
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000503:physiopathology / Q000601:surgery*; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000503:physiopathology / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged