"Bio-Chimney" Technique for Narrow Mitral Annulus in Adults.

Narrow mitral annulus is a common situation faced in adult patients. Choice of prosthetic valve in such cases is unclear. There are reported experiences with supra-annular mitral valve, Manouguian technique, "Chimney technique" with mechanical valve and Melody valve, the latter two being in children. We report a novel "Bio-Chimney" technique in which a bioprosthetic valve of a size appropriate for the patient is sutured to a polyester vascular graft which is then implanted to the native narrow mitral annulus in an adult patient with promising initial results.