title: Aortic Annular Enlargement during Aortic Valve Replacement.
abstract: In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.
authors.affiliation: University Hospital Center "Mother Theresa", Tirana, Albania.
authors.forename: Selman
authors.initials: S
authors.lastname: Dumani
authors.affiliation: University Hospital Center "Mother Theresa", Tirana, Albania.
authors.forename: Ermal
authors.initials: E
authors.lastname: Likaj
authors.affiliation: University Hospital Center "Mother Theresa", Tirana, Albania.
authors.forename: Laureta
authors.initials: L
authors.lastname: Dibra
authors.affiliation: University Hospital Center "Mother Theresa", Tirana, Albania.
authors.forename: Stavri
authors.initials: S
authors.lastname: Llazo
authors.affiliation: University Hospital Center "Mother Theresa", Tirana, Albania.
authors.forename: Ali
authors.initials: A
authors.lastname: Refatllari
keywords: AAE-aortic annulus enlargement; AVR-aortic valve replacement; Manouguian technique; PPM-patient - prosthesis mismatch; iEOA-indexed effective orifice area