Patch Enlargement of the Aortic and the Mitral Valve Rings with Aortic-Mitral Double-Valve Replacement

Manouguian, S.; Kirchhoff, P. G.

doi:10.1016/s0003-4975(10)61281-7

Cited by 25 publications

(8 citation statements)

References 3 publications

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“…61 In 1979, Manouguian and colleagues reported an anterior approach for aortic annular enlargement that allowed simultaneous enlargement of the mitral annulus. 62,63 In 1977, Kitamura (TWMU) introduced the coupled valve grafting method for enlargement of both the aortic annulus and the mitral annulus. With this method, prosthetic aortic and mitral valves are sewn onto a wedgeshaped vascular graft patch, and this patch is then sewn to the left atrial wall and aortic root after excision of the two native valves.…”

Section: Annular Enlargement and Patient-prosthesis Mismatchmentioning

confidence: 99%

Beginning and development of surgery for acquired valvular heart disease in Japan

Hara

2009

Gen Thorac Cardiovasc Surg

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The initiation and development of surgery for acquired valvular heart disease in Japan was reviewed. The first series of attempts at closed valvular surgery were performed in 1951-1952 by collaboration between the brothers Tohru and Shigeru Sakakibara in patients with pulmonary or mitral stenosis. During the popularization of closed valvular surgery, open heart surgery under direct vision was successfully performed by Shigeru Sakakibara with cooling of the body in 1954 and by using cardiopulmonary bypass (CPB) in 1956. With the development of CPB and artificial heart valves, closed valvular heart surgery was replaced by open surgery, which expanded rapidly during the 1960s and 1970s. Along with the serial introduction and improvement of mechanical vales thereafter, bioprosthetic valves were also introduced and were adopted for certain patients. Use of bioprosthetic valves in the aortic position exceeded 50% in 2005, along with the increase of elderly patients. Although trials of mitral valve plasty for mitral regurgitation were first done during the 1950s to 1960s in Japan, interest in valve plasty only increased during the late 1970s. Considering the patient's quality of life and the long-term results, mitral valve plasty became the major procedure (exceeding valve replacement) from 2004. In 2002, the Guideline for Surgical and Interventional Treatment of Valvular Heart Disease was published by a joint committee of the relevant academic societies, and it has made an important contribution to improving surgical outcomes.

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Section: Annular Enlargement and Patient-prosthesis Mismatchmentioning

confidence: 99%

Beginning and development of surgery for acquired valvular heart disease in Japan

Hara

2009

Gen Thorac Cardiovasc Surg

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“…In cases where the mitral or aortic valve diameters continued to be insufficient, we returned to the aortic root, visualizing the mitral annulus and placed repair sutures using 4-0 polypropylene thread at a distance of 2 mm from the junction with the inter-valvular trigone (Figure 1-C). We sectioned between the sutures (Figure 1-D), displacing the left atrial roof by approximately 10 mm at the trigone junction with the mitral annulus, as was described by MANOUGUIAN et al [4,5], but we did not extend the opening. The annuli were increased simultaneously with a bovine pericardial patch in the shape of a Gothic arch.…”

Section: Techniquementioning

confidence: 99%

“…This roof is closed by reconstruction with a patch [4,5]. Mitral and aortic valves each obtain a 4-mm increase in diameter.…”

Section: Commentsmentioning

confidence: 99%

“…Small mitral prostheses are also obstructive [3], and are rarely indicated. Manouguian's technique allows the implantation of adequate prostheses by simultaneously increasing the aortic and mitral valves [4,5]. Here we report on a modification of this technique, we present a case report and discuss these modifications and the technique's indication.…”

Section: Introductionmentioning

confidence: 99%

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Mitral-aortic annular enlargement: modification of Manouguian's technique

Costa¹,

Silva²,

Menezes³

et al. 2002

Rev Bras Cir Cardiovasc

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Abstract:We hereby present a technical modification for mitral-aortic annular enlargement. The mitral valve is replaced through the retro-septal approach, avoiding patches for left atrial roof closure. We report a mitral-aortic valve replacement in a patient whose original annuli would preclude adequate prostheses. The simultaneous annular enlargement may be necessary for avoiding patient-prosthesis mismatch and for reconstructing destroyed mitral and aortic annuli. The technique may minimize the risk of bleeding and of paravalvular leakage, using an approach well known to cardiac surgeons.

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“…Moreover, a small prosthesis in a narrow aortic annulus may not provide clinical or hemodynamic benefits to a large or physically active individual. Thus, an annulus-enlarging procedure such as that described by Manouguian and colleagues, 1 Nicks and colleagues, 2 or Konno and colleagues 3 is needed. We describe our experience of 17 patients in whom the Manouguian technique was used with modifications.…”

Section: Introductionmentioning

confidence: 99%

Enlargement of Small Aortic Annulus by Modified Manouguian's Technique

Sankar

Rajan

Singh

et al. 1999

Asian Cardiovasc Thorac Ann

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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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Patch Enlargement of the Aortic and the Mitral Valve Rings with Aortic-Mitral Double-Valve Replacement

Cited by 25 publications

References 3 publications

Beginning and development of surgery for acquired valvular heart disease in Japan

Beginning and development of surgery for acquired valvular heart disease in Japan

Mitral-aortic annular enlargement: modification of Manouguian's technique

Enlargement of Small Aortic Annulus by Modified Manouguian's Technique

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