title: Aortoventriculoplasty for correction of patient-prosthesis mismatch examples.
abstract: OBJECTIVE
  Patient-prosthesis mismatch is often considered as an important cause of adverse outcome following aortic valve replacement. A small annulus represents a challenge for the surgeon; yet can be best managed at the initial operation using relatively simple techniques, as later-on correction is often far more challenging. Corrective reoperations necessitate drastic root enlargement, along with the relief of subvalvular muscular obstruction.
  
  
  METHODS
  The Konno-type aorto-ventriculoplasty is preferred in the present case series in order to achieve a radical aortic annulus enlargement in difficult reoperation settings and to address the accompanying subvalvular obstruction due to muscular hypertrophy simultaneously as well, with the septal patch included in the technique.
  
  
  RESULTS
  This approach provides satisfactory relief of the obstruction at both valvular and subvalvular level and the benefits are immediately evident, as symptoms abruptly end in all cases.
  
  
  CONCLUSIONS
  Long-term outcome is also excellent in both clinical and haemodynamic terms, as reflected by the significant left ventricle mass regression, absence of symptoms and improved quality of life.
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey. Electronic address: kvural@tr.net.
authors: Kerem M
authors: KM
authors: Vural
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors: Sertan
authors: S
authors: Ozyalcin
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors: Ufuk
authors: U
authors: Turkmen
authors: Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.
authors: Tezcan
authors: T
authors: Bozkurt
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods*; D006801:Humans
keywords: Aortic valve; Heart valve prosthesis; Patient-prosthesis mismatch; Prosthesis fitting; Reoperation; Treatment outcome