Procedure

Supra-annular aortic valve replacement with a mechanical prosthesis

University Hospital, Rämistrasse 100, 8091 Zurich, Switzerland

^* Corresponding author: ^* Tel.: +41-44-255 3298; fax +41-44-255 4446. E-mail: marko.turina{at}usz.ch

Supra-annular placement of the aortic valve prosthesis is primarily used in small aortic annulus to prevent a patient-prosthesis mismatch. The most important surgical steps are: careful removal of the diseased valve including annular decalcification; assessment of the prosthesis seating to guarantee free movement of leaflets and to prevent obstruction of coronary orifices; implantation with interrupted stitches placed infra-annularly, with the prosthesis being seated in a supra-annular position. If necessary, a sub-annular resection of asymmetric septal hypertrophy should be carried out prior to placement of the prosthesis.

Key Words: Aortic prosthesis • Mechanical valve • Patient-prosthesis mismatch • Supra-annular placement