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Ann Thorac Surg 2002;73:725-728
© 2002 The Society of Thoracic Surgeons

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Original article: cardiovascular

Complete aortic root replacement in patients with small aortic annulus

^a Herz- und Gefaess-Klinik, Bad Neustadt, Germany

Accepted for publication October 20, 2001.

* Address reprint requests to Dr Urbanski, Herz- und Gefaess-Klinik, Salzburger Leite 1, 97616 Bad Neustadt, Germany
e-mail: urbanski{at}kardiochirurg.de

Background. We evaluated the effectiveness of our surgical method using a modified self-assembled valved composite graft in patients with a narrow aortic annulus.

Methods. Between August 2000 and May 2001, 10 consecutive patients with a narrow aortic annulus underwent replacement of the aortic valve and the ascending aorta using a valved composite graft with mechanical valve prosthesis. The indication for surgery was aneurysm of the ascending aorta (8 patients) and aortic dissection (2 patients). To avoid valve-patient mismatch, a modified self-assembled valved composite graft was used.

Results. There was no hospital mortality. Echocardiographic evaluation before discharge showed excellent hemodynamics with a mean transvalvular gradient of 10.7 mm Hg (standard deviation ± 2.8 mm Hg).

Conclusions. The described valved composite graft offers very good hemodynamic performance and is a simple and effective device to avoid valve-patient mismatch in patients with a small aortic annulus who need aortic root replacement.

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