Bilateral enlargement of the aortic valve ring for valve replacement in children. New operative technique.

We report a new technique for the bilateral enlargement of a small aortic anulus in two children by the insertion of a bifurcated teardrop-shaped Dacron fabric lined with a porcine pericardium. Our experience in two children indicates that this technique will permit the insertion of a prosthetic valve that is four sizes larger than that measured with the native anulus intact in children weighing around 15 kg. It entails no risk of distorting the mitral valve, damaging the conduction system, the main coronary arteries or their important trunks, or of leading to left ventricular dysfunction.