Introduction

摘要

Aortic valve replacement is one of the most common procedures performed by cardiac surgeons. The use of mechanical and stented bioprosthetic valves results in some residual degree of obstruction due to the sewing ring and struts. Although most patients may do well with implantation of a small valve, data exist to suggest that leaving a patient with a significant residual gradient may lead to poorer long-term results. Although many factors play into the significance of patient-prosthesis mismatch, all cardiac surgeons should be comfortable performing aortic root enlargement to facilitate placement of an appropriate sized valve. For young active patients and for patients with a large BSA, a 19- or 21-mm valve may not be suitable. Several techniques for annular enlargement have been described.