Intra-Arterial Aortoinfundibuloplasty: Hemodyamic and Anatomical Study of a New Method for the Enlargement of a Small Aortic Annulus

Abstract

A new method for prosthetic valve replacement in a small aortic annulus is described. An anatomical examination showed that the intra-arterial approach via the main pulmonary artery made it feasible to incise the aortopulmonary septum at the middle point of both coronary ostia and also to relieve left ventricular outflow tract obstruction with a two-dimensional patch. The pressure study in three mongrel dogs demonstrated that 6-mm augmentation of the host aortic annulus with this procedure made no significant difference in the pressure gradient between the right ventricle and the main pulmonary artery before and after operation. The right ventricular end-diastolic pressure did not show any significant change with respect to hemodynamics. It is expected from these results that our procedure could be used for the treatment of various types of left ventricular outflow tract stenosis without affecting the hemodynamics and, especially, right ventricular function.

Dupla ampliação anterior e posterior do anel aórtico para substituição valvar

“…Este folheto é liberado das aortoventriculoplastia, embora sendo o local indicado o seio coronariano direito, entre a comissura do folheto coronariano direito e esquerdo e o óstio coronariano direito (3,4) . Uma incisão anterior compreendendo o anel pulmonar foi avaliada experimentalmente em cães (32) . A forma final das incisões na aorta constitui uma letra Y invertida, lembrando a sugerida para ampliação da estenose supravalvar aórtica, com a finalidade de evitar distorções e corrigir disfunção da valva natural (33) .…”