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February 5, 2026Asian Cardiovascular and Thoracic Annals0 citations

Aortic annular enlargement using the Y-incision technique—How I do it

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XHXiaoqin HuaLCLenard Conradi

Key Result

The Y-incision aortic annular enlargement technique enables implantation of larger prostheses to avoid prosthesis-patient mismatch in patients with small aortic annuli.

Key Points

  • This study aims to outline the Y-incision technique for aortic annular enlargement and its effectiveness in valve replacement.
  • Utilized Y-incision approach to enlarge aortic annulus and root
  • Employed rectangular patch for enlargement
  • Used minimally invasive access for procedure
  • Integrated modified closure of aortotomy with ascending aortic replacement when necessary
  • Technique enables implantation of larger prostheses
  • Promising early outcomes observed
  • Reduces risk of prosthesis-patient mismatch
  • No negative impact on mitral geometry

Structured PICO

P
Population
Patients with small aortic annuli undergoing aortic valve replacement
I
Intervention
Y-incision aortic annular enlargement technique using a rectangular patch

The Y-incision aortic annular enlargement technique enables the implantation of larger prostheses during aortic valve replacement to avoid prosthesis-patient mismatch.

Limitations

  • Long-term follow-up and multicenter comparison are required to evaluate its benefits and potential risks.
  • long-term follow-up required
  • multicenter comparison required

Abstract

The Y-incision aortic annular enlargement technique offers a reliable solution for the aortic valve replacement in patients with small aortic annuli. By enlarging the annulus and root using a Y-incision and rectangular patch, this technique enables implantation of significantly larger prostheses to effectively avoid prosthesis-patient mismatch without affecting mitral geometry. Based on our experience using minimally invasive access, tailored patch design, modified closure of aortotomy, and integration with ascending aortic replacement when needed, the technique is reproducible and adaptable. Early outcomes are promising, though long-term follow-up and multicenter comparison are required to evaluate its benefits and potential risks.

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Cite This Study

Hua et al. (2026) studied Small aortic annuli requiring aortic valve replacement. Y-incision aortic annular enlargement technique was evaluated. The Y-incision aortic annular enlargement technique enables implantation of larger prostheses to avoid prosthesis-patient mismatch in patients with small aortic annuli.

synapsesocial.com/papers/698435d5f1d9ada3c1fb50cfhttps://doi.org/10.1177/02184923261419650
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