Aortoventriculoplasty after a prior posterior root enlargement (Manougian): Case report

A patient with congenital bicuspid aortic stenosis had an open commissuroto my followed 3 years later by a Manougian's operation along with an aortic v alve replacement. Nine years later, due to residual aortic stenosis, a Konn o's anterior root enlarging procedure with an aortic valve replacement was successfully done. Good relief of aortic and subaortic stenosis and the abs ence of significant gradient across the left ventricular outflow tract led us to believe that successful and effective relief could be obtained by add ing a Konno-type of enlargement to a previously performed posterior enlarge ment procedure.