Adjustable sinotubular junction for aortic valve reimplantation procedures.
Sinotubular junction size in aortic valve reimplantation procedures is usually predetermined on the basis of mathematical calculations and intraoperative measurements. We propose a new method for aortic valve reimplantation by which intraoperative measurements can be eliminated and sinotubular junction size adjusted after cross clamp removal to fit the patient's need. Aortic valve commissures are reimplanted in the expandable skirt of a Valsalva (Vascutek, Renfrewshire, Scotland) graft to realize an oversized sinotubular junction that is subsequently reduced to the proper size by wrapping, with Dacron rings of decreasing size, the neo-sinotubular ridge under transesophageal echocardiographic guidance.
Maselli
Daniele
D
Cardiothoracic Department, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. dmaselli@tiscali.it
Guarracino
Fabio
F
Bajona
Pietro
P
Bellieni
Luca
L
Minzioni
Gaetano
G
D000328:Adult; D001011:Aorta; D001014:Aortic Aneurysm / Q000150:complications / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000150:complications / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D004867:Equipment Design; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D012092:Replantation / Q000379:methods*; D025321:Surgery, Computer-Assisted