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Enlargement of the narrow aortic root and oblique insertion of a St Jude prosthesis.

The aortic root was enlarged and a St Jude Medical valve obliquely inserted in 11 patients. Prosthetic valve sizes at least one, but often two, sizes larger than that which would normally be accommodated by the dimensions of the host aortic annulus were used. Closure of the valve was not affected by obliquity. This simple technique is recommended whenever the host aortic annulus does not allow the insertion of a substitute valve of an appropriate size.