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The Journal of Thoracic and Cardiovascular Surgery, Vol 78, 402-412, Copyright © 1979 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
S Manouguian and W Seybold-Epting
This communication describes a new surgical procedure of enlarging the
narrow aortic valve ring by extending the aortic incision through the
fibrous origin of the aortic leaflet of the mitral valve into this leaflet.
A fusiform patch is sutured to the V-shaped defect in the aortic leaflet of
the mitral valve and in the aortic anulus. This procedure permits the
replacement of the aortic valve by a suitable prosthesis. Between June of
1976 and February of 1978, eight patients underwent this surgical
procedure. At the time of operation the patients were between 8 and 50
years old. The estimated enlargement of the aortic root ranged from 10 to
25 mm. The operative technique is described, peculiarities of this method
are discussed, and the results are reported. Six to 27 months following
operation, the clinical condition of six patients is good. Four patients
show no impairment of mitral valve function. In one case, preoperatively
diagnosed mitral incompetence persists. In another patient the pericardial
patch broke from the aortic leaflet of the mitral valve, so that the valve
had to be replaced on the fourth postoperative day. One patient died of
myocardial necrosis because of insufficient myocardial protection during
operation. One child with acute aortic insufficiency caused by
staphylococcal endocarditis and congestive heart failure died of septicemia
3 months postoperatively. Mitral incompetence was not detectable in this
child.
ARTICLES
Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet. New operative technique
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