title: Optimal size of prostheses for functioning of the aortic prosthetic valve in aortic and mitral valve replacement with annular enlargement through Manouguian's technique.
abstract: There is not yet agreement about the optimal size of the prostheses in aortic and mitral valve replacement with Manouguian's technique. In this technique, the aortic prosthetic valve can be pushed upon the mitral prosthesis which may cause dysfunction of the aortic prosthetic valve. The aim of this study was to clarify the size of the prostheses needed to avoid dysfunction of the aortic prosthetic valve. Three patients underwent aortic and mitral valve replacement through this procedure. Two of them had active aortic and mitral valve endocarditis. Aortomitral continuity involved with abscesses could be approached and completely excised using this technique. All patients survived the operation, but 1 of them suffered aortic mechanical valve dysfunction for the reason stated. Anatomical analysis of the geometrical relation of the 2 prosthetic valves suggests that the mitral annulus should be enlarged less than 25 mm to avoid dysfunction of the aortic prosthetic valve.
authors.affiliation: Nagoya University Graduate School of Medicine, Department of Cardiothoracic Surgery, Japan.
authors.forename: Atsuo
authors.initials: A
authors.lastname: Maekawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Akihiko
authors.initials: A
authors.lastname: Usui
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ohara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takagi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masumoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Yano
authors.forename: Masato
authors.initials: M
authors.lastname: Usui
authors.forename: Yuji
authors.initials: Y
authors.lastname: Narita
authors.forename: Haruki
authors.initials: H
authors.lastname: Takemura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mizutani
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ueda
mesh_terms: D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D011474:Prosthesis Design; D011859:Radiography; D020127:Recovery of Function / Q000502:physiology*; D016896:Treatment Outcome