title: [Surgical technique of aortic valve replacement for small aortic annulus in elderly patients].
abstract: Recent reports have shown that aortic valve replacement in elderly patients over 65 years with atherosclerotic aortic stenosis and a small aortic annulus is possible by using a small sized bioprosthesis (Carpentier-Edwards pericardial valve). Here we present out surgical technique. Firstly, the native calcified aortic valve was removed completely to gain total exposure of the surrounding aortic root and sinus of Valsalva like Bentall procedure. Secondly, a small sized bioprosthesis was implanted with intermittent noneverting mattress 2-0 sutures with spaghetti and small polytetrafluoroethylene (PTFE) felt. Aortic annulus is the dilated by inserting Hegar dilator sizing from 25 to 27 mm. Therefore, aortic valve replacement for small aortic annulus in intra- or supra-annular position should be easily accomplished. Good surgical results and hemodynamic state were achieved in 25 consecutive cases using this technique.
authors.affiliation: Department of Cardiovascular Surgery, Cardiovascular Center Kohsei General Hospital, Mihara, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Hata
authors.forename: K
authors.initials: K
authors.lastname: Fujiwara
authors.forename: H
authors.initials: H
authors.lastname: Furukawa
authors.forename: Y
authors.initials: Y
authors.lastname: Tsushima
authors.forename: H
authors.initials: H
authors.lastname: Yoshitaka
authors.forename: M
authors.initials: M
authors.lastname: Kuinose
authors.forename: H
authors.initials: H
authors.lastname: Minami
authors.forename: A
authors.initials: A
authors.lastname: Ishida
authors.forename: K
authors.initials: K
authors.lastname: Tamura
authors.forename: T
authors.initials: T
authors.lastname: Totsugawa
authors.forename: H
authors.initials: H
authors.lastname: Kanemitsu
authors.forename: M
authors.initials: M
authors.lastname: Ozawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D001705:Bioprosthesis; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011379:Prognosis; D011474:Prosthesis Design; D017755:Prosthesis Fitting; D013536:Suture Techniques