title: Aortic root replacement for prosthetic aortic valve detachment without regurgitation and with enlarged Valsalva's sinuses and complete atrioventricular block caused by Takayasu's aortitis.
abstract: We replaced the aortic root in a 43-year-old woman with Takayasu's aortitis associated with prosthetic aortic valve detachment. The patient's aortic valve had been replaced when she was 31 years old with a mechanical prosthesis to treat aortic regurgitation. Though C-reactive protein was kept almost normal with prednisolone, complete atrioventricular block suddenly appeared 12 years after the first operation. After the implantation of an artificial pacemaker, we closely followed up aortic root status. Aortography and echocardiography showed that the valve moved up and down, probably due to enlargement of the sinuses of Valsalva, without perivalvular leakage. We removed the prosthetic aortic valve, which was partially detached from the aortic valve ring at the right- and non-coronary cusps and successfully replaced the aortic root with a mechanical prosthesis inserted into a 26 mm woven graft. Although the postoperative course was uneventful, we closely continue to observe the case and to administer of antiinflammatory medication.
authors.affiliation: Department of Cardiovascular Surgery, Higashitoride Hospital, Toride, Ibaraki, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Shonosuke
authors.initials: S
authors.lastname: Matsushita
authors.forename: Shuichi
authors.initials: S
authors.lastname: Okawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamabuki
authors.forename: Seigo
authors.initials: S
authors.lastname: Gomi
authors.forename: Teruo
authors.initials: T
authors.lastname: Hiyama
mesh_terms: D000328:Adult; D001011:Aorta / Q000601:surgery; D001014:Aortic Aneurysm / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D002304:Cardiac Pacing, Artificial; D004108:Dilatation, Pathologic; D005260:Female; D006327:Heart Block / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006350:Heart Valve Prosthesis; D006801:Humans; D011475:Prosthesis Failure; D012850:Sinus of Valsalva / Q000473:pathology*; D013625:Takayasu Arteritis / Q000150:complications*; D014463:Ultrasonography