Surgical Experience with Doty's Repair for Supravalvular Aortic Stenosis

Abstract

The surgical treatment of severe supravalvular aortic stenosis by conventional, asymmetrical, one point patch aortoplasty across the narrowed area has been associated with a substantial incidence of residual stenosis and reoperations. Almost symmetrical relief of such stenosis was achieved with Doty's extended aortoplasty in 5 patients in whom left ventricular aortic gradient was reduced from 60–170 nun Hg to 0–25 mm Hg. This technique of inserting an inverted V-shaped gusset across the stenosed segment into the right coronary sinus and non-coronary sinus, restores the aortic root geometry, provides more predictable relief of aortic obstruction and also improves aortic valve function. Associated procedures involved relief of coarctation of aorta and innominate artery stenosis in 1 case and repair of aortic valve and mitral valve in another case.