Aortic Annular Enlargement during Aortic Valve Replacement


  • Selman Dumani University Hospital Center ”Mother Theresa”, Tirana
  • Ermal Likaj University Hospital Center ”Mother Theresa”, Tirana
  • Laureta Dibra University Hospital Center ”Mother Theresa”, Tirana
  • Stavri Llazo University Hospital Center ”Mother Theresa”, Tirana
  • Ali Refatllari University Hospital Center ”Mother Theresa”, Tirana



AAE-aortic annulus enlargement, Manouguian technique, PPM-patient - prosthesis mismatch, AVR-aortic valve replacement, iEOA-indexed effective orifice area


In the surgery of aortic valve replacement is always attempted, as much as possible, to implant the larger prosthesis with the mains goals to enhance the potential benefits, to minimise transvalvular gradient, decrease left ventricular size and avoid the phenomenon of patient-prosthesis mismatch. Implantation of an ideal prosthesis often it is not possible, due to a small aortic annulus. A variety of aortic annulus enlargement techniques is reported to avoid patient-prosthesis mismatch. We present the case that has submitted four three times open heart surgery. We used Manouguian technique to enlarge aortic anulus with excellent results during the fourth time of surgery.


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How to Cite

Dumani S, Likaj E, Dibra L, Llazo S, Refatllari A. Aortic Annular Enlargement during Aortic Valve Replacement. Open Access Maced J Med Sci [Internet]. 2016 Sep. 2 [cited 2022 Aug. 14];4(3):455-7. Available from:



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