[Aortic valve replacement for narrow aortic ostium, supraannular insertion at noncoronary sinus with Bjrk-Shiley valve].

Fifteen patients with small aortic annuli underwent aortic valve replacement either isolated or combined with other procedures. All patients had aortic valve replacement with Björk-Shiley prosthesis larger than the aortic annulus. The prosthesis was sutured in a supraannular position in the area corresponding to the noncoronary sinus. There was no hospital and late death. In the long term follow up, 21 mm prosthetic gradients by doppler method ranged from 17 to 43 (29.9 +/- 7.3) mmHg in patients with supraannular aortic valve replacement and from 20 to 45 (27.4 +/- 7.1) mmHg in patients with standard aortic valve replacement, which showed statistically no significant difference. Because this technique allows the insertion of prosthetic valves one sizes larger than the size of aortic annulus, it will produce stable hemodynamic result. As a consequence, those procedure such as transannular patch reconstruction will be avoided.