Simplified Manouguian's aortic annular enlargement for aortic valve replacement

Mayumi, Hisanori; Toshima, Yoshihiro; Kawachi, Yoshito; Tokunaga, Kazutoshi; Yasui, Hirofumi

doi:10.1016/0003-4975(95)00335-i

Cited by 10 publications

(5 citation statements)

References 5 publications

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“…We never prefer to extend the aortic incision farther than aortic‐mitral junction during posterior aortic root enlargement procedures. This strategy can protect late mitral valve dysfunction 16 …”

Section: Commentsmentioning

confidence: 99%

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Does Aortic Root Enlargement Impair the Outcome of Patients With Small Aortic Root?

et al. 2006

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Section: Commentsmentioning

confidence: 99%

“…This strategy can protect late mitral valve dysfunction. 16 Reoperation can be performed without any additional risk in patients received posterior aortic root enlargement. We could not differentiate the pericardium from the native aortic wall during the reoperation.…”

Section: Commentsmentioning

confidence: 99%

Does Aortic Root Enlargement Impair the Outcome of Patients With Small Aortic Root?

et al. 2006

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“…5 Secondly, a classical aortic root enlargement (ARE) procedure would be necessary for younger patients. [34][35][36][37] Kitamura et al reported successful middle-term results after comparing the standard AVR in small annular patients. 38,39 However, the increased operative risk with these procedures must be considered.…”

Section: Selection Of Devices For the Predicted 'Mismatch' Patientsmentioning

confidence: 99%

Functional Evaluation of the Bileaflet Mechanical Valve in the Aortic Position Using Dobutamine-Stress Echocardiography

et al. 1998

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The issue of valve prosthesis-patient mismatch in small annular patients is still controversial. The hemodynamic function of bileaflet mechanical valves in the aortic position was examined using dobutamine-stress echocardiography. Forty-four patients were enrolled in the study and divided into 5 groups, according to prosthesis size, from 21 mm to 29 mm. The aortic peak pressure gradient (APG) increased significantly in all groups with dobutamine-stress and exceeded 50 mmHg in 83% of the 21-mm group, in 64% of the 23-mm group, and in 33% of the 25-mm group. The APG even exceeded 80 mmHg in 22% and 18% of the 21-mm and 23-mm groups, respectively. In these cases, the potential of 'valve prosthesis-patient mismatch' was considered. From the relationship between the APG and the prosthesis valve area index (VAI), 'critical VAIs' were found where patients were likely to enter the 'mismatch' status; that is, 1.22 and 1.77 cm2/m2, respectively, for the 5 and 10 microg/kg per min stages of dobutamine stress. This critical VAI range is useful in predicting the 'mismatch' patients preoperatively. Alternative procedures or prostheses should then be selected for them.

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“…16,17 Similar to several previous reports, 18,19 patch enlargement did not cause any abnormality in the mitral valve leaflets with subsequent insufficiency. As suggested by Mayumi and colleagues, 20 we did not extend the aortic incision beyond the aortic-mitral junction. This technique may help to preserve mitral valve function after posterior aortic root enlargement.…”

Section: Discussionmentioning

confidence: 99%