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Ann Thorac Surg 1988;46:427-429
© 1988 The Society of Thoracic Surgeons

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Articles

Extended Aortoplasty to Relieve Supravalvular Aortic Stenosis

Division of Cardiothoradc Surgery and the Department of Pediahics, University of Rochester Medical Center, Rochester, NY

Accepted for publication April 28, 1988.

^* Address reprint requests to Dr. Stewart, Division of Cardiothoradc Surgery, University of Rochester Medical Center, Rochester, NY 14642

An extended aortoplasty was used to relieve severe supravalvular aortic stenosis in 5 patients whose preoperative left ventricular-aortic gradient ranged from 85 to 140 mm Hg (median, 120 mm Hg). The stenotic ring above the commissures was divided in two places by an inverted U incision extending into the right and noncoronary sinuses. A distal vertical incision in the ascending aorta converted this into an inverted Y. The ridge above the left coronary sinus was excised. The aortic incision was repaired with an inverted Y-shaped Dacron gusset. The postoperative gradient ranged from 0 to 30 mm Hg (median, 15 mm Hg). The extended aortoplasty provides excellent relief of supravalvular aortic stenosis and, in addition, restores the aortic root geometry to a much more anatomical configuration than is achieved with the simple patch technique.

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