[A technique of successfully performing an annuloplasty for narrowed aortic valvular annulus in aortic valve replacement].

We previously reported that a significant reduction in both myocardial weight and left ventricular end-diastolic volume weight and left ventricular end-diastolic volume was achieved with the use of an artificial valve of 21 mm size in aortic valve replacement (AVR) performed on aortic stenosis patients with a body surface area of less than 1.4 m2. In those patients with a narrower valvular annulus on a unit body surface area basis, however, we have aggressively performed an operation of enlarging the valvular annulus in conjunction with AVR with a similar satisfactory hemodynamic improvement invariably in all cases, including 3 without autologous blood transfusion. In this paper mention is made, based on our experiences gained so far, of some points of critical technical importance for the successful performance of AVR involving annuloplasty, specification by the Manouguian's and Konno's procedure.