| Abstract
| - To avoid the problem of valve prosthesis/patient mismatch in the latepostoperative period, we have adopted patch enlargement of the small aorticannulus in 33 patients having undergone aortic valve replacement since1975, when the aortic annulus could not accept a large enough prosthesis.The mean age was 40 years, including 2 children aged 4. The technique ofpatch enlargement utilized was Nicks' method wherein the incision does notextend onto the mitral leaflet. In 31 adult patients, the aortic annulusbefore enlargement ranged in diameter from 18 to 24 mm with an average of20.8 mm. After enlargement, the diameter of the annulus was 25.0 mm onaverage. In 2 children, the mean diameter of the annulus was enlarged from16.5 mm to 20.5 mm. There were 2 early deaths in the initial series and 2late deaths. Patch enlargement of the small aortic annulus is a simple,safe, and effective adjunct permitting the insertion of a valve one or twosizes larger than that which could be accommodated by the nativeannulus.
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