title: A case of early failure of the freestyle stentless bioprosthesis due to cuspal tear.
abstract: We report an unusual case of early structural failure of the Freestyle stentless bioprosthesis 22 months after initial implantation. A 71-year-old woman, who had undergone stentless valve implantation by the subcoronary method, presented with a new diastolic murmur and progressive congestive heart failure 20 months after the initial implantation. Reoperation was performed using a stented bioprosthesis. The explanted prosthesis showed a tear along the annulus in one cusp. There were no findings of bacterial endocarditis or other macroscopical changes including calcification, thrombus attachment and pannus formation. It is believed that the cause of the cuspal tear was primary tissue failure. Further study is needed to clarify the incidence of this event.
authors.affiliation: Department of Cardiovascular Surgery, Chiba Cardiovascular Center, Chiba, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Murayama
authors.forename: Soichi
authors.initials: S
authors.lastname: Asano
authors.forename: Masanao
authors.initials: M
authors.lastname: Oba
authors.forename: Hidemi
authors.initials: H
authors.lastname: Owada
authors.forename: Katuhiko
authors.initials: K
authors.lastname: Tatuno
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D011475:Prosthesis Failure; D012086:Reoperation; D012421:Rupture / Q000209:etiology; D013997:Time Factors