Background: Manouguian aortic root enlargement (ARE)
has been a standard root enlargement procedure to assist in patients
with a small annular size. We describe a modification to the Manouguian
ARE similar to Yang et al. This approach could serve as an alternate
technique for performing ARE; to date only case reports have defined
this approach and no studies have evaluated its efficacy or safety.
Methods: A retrospective case series was performed on
patients who underwent ARE for surgical aortic valve replacement via the
modified Manouguian procedure at a single institution. Thirteen patients
were identified between 2015-2021, and all surgeries were performed by a
single operator. Data were collected via the Society of Thoracic
Surgeons database and chart review. The primary outcome was difference
in valve size after the procedure. Results: The most
common indication for surgery was aortic stenosis (12, 92%), with the
most common etiology being degenerative calcification (7, 54%).
Congenital bicuspid or uni-cuspid valves were identified in 5 (38%)
patients. The majority (10, 77%) of patients received a mechanical
valve. This procedure was successfully performed in all 13 of the
patients. Additionally, 13 of the 13 patients (100%) were upsized to a
satisfactory valve size based on pre-operative echocardiography sizing.
Conclusions: The modified Manouguian aortic enlargement
technique can be safely and effectively used as an aortic enlargement
procedure in a broad sample of patients.