{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T17:32:36Z","timestamp":1758475956254,"version":"3.38.0"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[1994,8,1]],"date-time":"1994-08-01T00:00:00Z","timestamp":775699200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Surgery"],"published-print":{"date-parts":[[1994,8]]},"abstract":"<jats:p> Technical considerations regarding the insertion of 21-mm Bj\u00f6rk-Shiley Monostrut valves, particularly regarding decalcification of a calcified annulus with an ultrasonic surgical dissector, in patients with aortic stenosis and a narrow aortic root are described. Short-term follow-up (mean(s.d.) 37(10) months) is also presented. Ten adults whose body surface area ranged from 1.26 to 1.47 m<jats:sup>2<\/jats:sup> underwent implantation of a 21-mm valve without outflow patch or annuloplasty. One operative death occurred; there were no other complications. The New York Heart Association functional class decreased from a mean of 3.2 before surgery to 1 in all cases. The mean(s.d.) end-diastolic volume decreased from 129(44) ml to 80(21) ml, and the end-systolic volume from 41 (21) ml to 27(10) ml ( P&lt; 0.01). The mean(s.d.) maximum velocity, as measured by Doppler echocardiography in the aortic position, decreased from 4.35(0.55) m\/s to 2.42(0.59) m\/s ( P&lt; 0.01). This degree of improvement was not meaningfully different from that of the 23-mm valve. However, there was a negative correlation between the reduction in left ventricular mass and body surface area ( r = \u22120.72, P&lt; 0.03). It is concluded that the 21-mm Bj\u00f6rk-Shiley Monostrut valve can be inserted using a modified technique in most patients with a narrow aortic root. This size valve is satisfactory when the patient's body surface area is &lt; 1.45 m<jats:sup>2<\/jats:sup>. <\/jats:p>","DOI":"10.1177\/096721099400200405","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T16:44:51Z","timestamp":1727109891000},"page":"456-459","source":"Crossref","is-referenced-by-count":4,"title":["Use of the 21 -mm Bj\u00f6rk-Shiley Monostrut Valve in Patients with a Narrow Aortic Root"],"prefix":"10.1177","volume":"2","author":[{"given":"K.","family":"Hashimoto","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K.","family":"Mashiko","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Horikoshi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Kurosawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Arai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Jikei University School of Medicine, 3-25-8, Nishishinbashi, Minatoku, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[1994,8,1]]},"reference":[{"key":"bibr1-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1136\/thx.25.3.339"},{"key":"bibr2-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)38105-X"},{"key":"bibr3-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)39673-4"},{"key":"bibr4-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90068-9"},{"key":"bibr5-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197412052912304"},{"key":"bibr6-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)61373-2"},{"key":"bibr7-096721099400200405","first-page":"2128","volume":"35","author":"Kitamura M","year":"1987","journal-title":"Nippon Kyobu Geka Gakkai Zasshi"},{"key":"bibr8-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)62182-0"},{"key":"bibr9-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)41310-X"},{"key":"bibr10-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0011-3840(79)80010-6"},{"key":"bibr11-096721099400200405","doi-asserted-by":"publisher","DOI":"10.3109\/14017438609105929"},{"key":"bibr12-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(85)80322-3"},{"key":"bibr13-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(19)34871-8"},{"key":"bibr14-096721099400200405","first-page":"72","volume":"33","author":"Nakano S","year":"1985","journal-title":"Nippon Kyobu Geka Gakkai Zasshi"},{"key":"bibr15-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)60034-3"},{"key":"bibr16-096721099400200405","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.80.3.504"}],"container-title":["Cardiovascular Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/096721099400200405","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/096721099400200405","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T22:37:38Z","timestamp":1740868658000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/096721099400200405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1994,8]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1994,8]]}},"alternative-id":["10.1177\/096721099400200405"],"URL":"https:\/\/doi.org\/10.1177\/096721099400200405","relation":{},"ISSN":["0967-2109"],"issn-type":[{"type":"print","value":"0967-2109"}],"subject":[],"published":{"date-parts":[[1994,8]]}}}