Plan #4: Management of AS & ARR: o Konno-Rastan aortic ventriculoplasty o Ross technique o Konno-Ross technique o Cooley apico-aortic valved conduit ...
Surgical Tactics for Small Aortic Annulus Ezzeldin A. Mostafa, MD, PhD, MBA Professor of Cardiovascular & Thoracic Surgery Ashraf A. Elmidany, MD, PhD Associate Professor of Cardiovascular & Thoracic Surgery Cardiovascular Hospital, Ain Shams University, Cairo, Egypt
Learning Objectives • AV Complex: the aortic valve & aortic root anatomic structures with emphasis on the anatomy of the VAJ (and its definitions). • The concept/phenomenon of valve prosthesis/patient mismatch (VP–PM). • Options to prevent VP-PM. o Use better performing prosthesis ▪ Newer generation supra-annular bioprosthesis ▪ Newer generation mechanical prosthesis ▪ Stentless bioprosthesis ▪ Sutureless bioprosthesis o Aortic root enlargement (ARE) or aortic root replacement (ARR) o Transcatheter aortic valve implantation (TAVI) • Plan #1: Management of AS & ARE: o One size: Supra-annular tilting technique o 2 sizes: Nicks-Nunze technique o 3 sizes: Rittenhouse-Manouguian technique & its modifications o 4 sizes: Yamaguchi technique • Plan #2: Management of AS & ARE: o Modified Manouguian-Seybold-Epting technique o Kitamura (Coupling valve enlargement) technique & its modifications • Plan #3: Management of AS & ARR: o Translocation technique + coronary reimplantation • Plan #4: Management of AS & ARR: o Konno-Rastan aortic ventriculoplasty o Ross technique o Konno-Ross technique o Cooley apico-aortic valved conduit (AAVC)
