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Enlargement of Small Aortic Annulus by Modified Manouguian's Technique

Madras Medical Mission Institute of Cardiovascular Diseases Chennai, India

For reprint information contact: Kotturathu Mammen Cherian, FRACS Tel: 91 44 625 9801 Fax: 91 44 625 9920 Madras Medical Mission, Institute of Cardiovascular Diseases, 4A, Dr. Jayalalitha Nagar, Mogappair East, Chennai 600050, Tamil Nadu, India.

From January 1981 to June 1994, 17 patients underwent aortic annulus enlargement by a modified Manouguian's technique. A small aortic root associated with stenotic lesions was the main indication. The ages of the patients ranged from 5 to 55 years (mean, 21 ± 14 years). There were 10 males and 7 females. Four had concomitant mitral valve replacement, 2 had open mitral valvotomy, 1 underwent ventricular septal defect closure, excision of a subaortic membrane, and ascending aortic replacement. The aortic roots were enlarged to between 20 to 30 mm. A Dacron patch was used in 16 patients and glutaraldehyde-treated autologous pericardium was used in 1. Two patients (12%) died in the postoperative period, 1 due to hemorrhage and the other due to septicemia. Mitral regurgitation (grade 1) was seen in 1 patient postoperatively but there was no further deterioration on serial evaluation. Four patients were lost to follow-up. Of the 11 followed up over a period of 10 years, 7 were in New York Heart Association functional class I and 4 were in class II.

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