Reoperation for early failure of a freestyle bioprosthesis using a full root technique.
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.
Kitamura
Aki
A
Department of Thoracic Cardiovascular Surgery, Kobe General Hospital, Kobe, Japan.
Handa
Nobuhiro
N
Shomura
Yu
Y
Wakiyama
Hidetaka
H
Shinka
Masahiko
M
Fujiwara
Hiroshi
H
Nasu
Michihiro
M
Tanabe
Kazuaki
K
Tani
Tomoko
T
Morioka
Shigefumi
S
Okada
Yukikatsu
Y
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