aortic root angioplasty
Surgical technique to enlarge the aortic annulus and root to accommodate a larger prosthetic valve, often using patch material.
Full Definition
A surgical procedure performed during aortic valve replacement to enlarge the aortic annulus and root when the patient's native anatomy is too small to accommodate an adequately sized prosthetic valve. This technique involves extending the aortotomy incision into the left ventricular outflow tract and using patch material (typically pericardium or synthetic material) to enlarge the area. Aortic root angioplasty is indicated when significant patient-prosthesis mismatch would otherwise occur, particularly in patients with small aortic roots or when a larger valve size is needed for optimal hemodynamics. The procedure increases the effective orifice area and reduces postoperative gradients, improving long-term outcomes. Various techniques exist, including the Nicks procedure (enlargement into the anterior mitral leaflet) and Manouguian technique (enlargement into the left atrium).
Usage
Usage note: Specify the technique used (Nicks, Manouguian) and patch material in operative reports.
In Context
- "Aortic root angioplasty was performed using a pericardial patch to accommodate a 23mm bioprosthetic valve." — operative report
- "The Manouguian technique for aortic root angioplasty was selected to avoid injury to the anterior mitral leaflet." — surgical case discussion