A Technique for Avoiding Patient-Prosthesis Mismatch in the Small Aortic Root

In the small aortic root, extremely weakened tissue and extensive calcification predispose toward the implantation of small prostheses, anastomotic bleeding, and paravalvular leaks. We describe a procedure in which a “homemade” composite mechanical prosthesis‐conduit is implanted in a supra‐annular position in two patients with a small aortic root. This technique facilitates the placement of a larger prosthesis, thus avoiding patient–prosthesis mismatch. doi: 10.1111/jocs.12741 (J Card Surg 2016;31:309–310)