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Excision of a Subvalvular Ring Followed by AVR With LVOT Enlargement
Gaudiani V, Tsau P. Excision of a Subvalvular Ring Followed by AVR With LVOT Enlargement. June 2025. doi:10.25373/ctsnet.29386448
This video illustrates the excision of a subvalvular ring in a 59-year-old woman with aortic regurgitation.
A femoral venous cannula and direct aortic cannulation were performed. The aorta was cross-clamped and opened. The valve was excised, which facilitated the assessment of the subvalvular ring. She required a 27 mm biological valve, so a left ventricular outflow tract (LVOT) enlargment was needed, which also facilitated visualization of the LVOT. The ridge was clearly visible, including part of the ring on the mitral leaflet and under the right coronary cusp. The LVOT was fully opened. The ring formed a U shape that required complete excision.
After excision, a 34 mm Dacron tube graft was used to create a flame-shaped patch that was employed for the enlargement, and the biological valve was placed. The remaining portion of the patch was used to close the aorta.
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