Wall rupture of Medtronic Freestyle stentless porcine aortic root bioprosthesis.
The Medtronic Freestyle stentless bioprosthetic valve provides excellent hemodynamics and long-term durability. However, several studies have reported mid-term structural valve deterioration unique to cases of Freestyle bioprosthesis implantation. According to these reports, the degeneration of the porcine aortic wall causes the dilatation and disruption of the sinus of Valsalva. We encountered a very rare case of an 8 mm-long tear located just above the inflow end of the Dacron cloth. The sudden rupture of the bioprosthetic aortic wall formed a pseudoaneurysm that compressed and almost occluded the pulmonary artery leading to low cardiac output syndrome and shock.
Mizuno
Tomohiro
T
Department of Cardiovascular Surgery, Machida Municipal Hospital, Machida, Tokyo, Japan. t-mizuno@yhc.att.ne.jp
D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology; D000818:Animals; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology; D001021:Aortic Valve / Q000601:surgery*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D001705:Bioprosthesis; D002303:Cardiac Output, Low / Q000209:etiology; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D006801:Humans; D011474:Prosthesis Design; D011475:Prosthesis Failure; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D012086:Reoperation; D012770:Shock, Cardiogenic / Q000209:etiology; D013552:Swine; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome