title: Reoperation for early failure of a freestyle bioprosthesis using a full root technique.
abstract: The case is reported of a 65-year-old male who required reoperation for early failure of a Freestyle stentless valve aortic root bioprosthesis implanted using the full root technique. The bioprosthesis had been implanted to treat annuloaortic ectasia associated with severe aortic regurgitation (AR). At 18 months postoperatively, a new diastolic murmur developed, though without complaint by the patient. Transthoracic echocardiography demonstrated severe AR with aneurysmal dilatation of the non-coronary porcine sinus of Valsalva. Pseudoaneurysm formation, associated with perforation of the non-coronary sinus of Valsalva of the bioprosthesis, was observed at surgery. On inspection, the pseudoaneurysm had pushed the commissures inward, and had created severe aortic valve regurgitation. No infection or calcification was detected on the Freestyle valve, and the aortic root was successfully reconstructed using a composite graft.
authors.affiliation: Department of Thoracic Cardiovascular Surgery, Kobe General Hospital, Kobe, Japan.
authors.forename: Aki
authors.initials: A
authors.lastname: Kitamura
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Handa
authors.forename: Yu
authors.initials: Y
authors.lastname: Shomura
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Wakiyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shinka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nasu
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Tanabe
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tani
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Morioka
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000368:Aged; D000783:Aneurysm / Q000175:diagnosis / Q000601:surgery; D017541:Aneurysm, False / Q000175:diagnosis / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects*; D004108:Dilatation, Pathologic / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D012086:Reoperation