title: [Prosthetic aortic valve dysfunction due to projection of the left ventricular outflow septum].
abstract: Prosthetic valve dysfunction at the aortic position is generally caused by either pannus overgrowth or thrombus or both. We encountered a case with prosthetic valve dysfunction who had undergone an aortic valve replacement 4 years and 5 months before, receiving SJM-HP 21 mm. During the initial operation, a prosthetic valve was implanted parallel to the ventricular septum and slightly up toward the non-coronary sinus (Olin technique) because of a narrow aortic annulus. Before re-do surgery, Doppler echocardiography and cinefluoroscopy showed an incomplete opening of 1 leaflet of the prosthetic valve. At the re-do operation, it was observed that the movement of the anterior leaflet of the prosthetic valve was disturbed by the projecting ventricular septum. After the projecting ventricular septum was excised, SJM-regent 17 mm valve was implanted perpendicular to the septum at the supra-annular position. Postoperative course was uneventful. The postoperative aortic peak pressure gradient decreased to 25 mmHg by Doppler echocardiography.
authors.affiliation: Department of Cardiovascular Surgery, Shimane Prefectural Central Hospital, Izumo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Inoue
authors.forename: M
authors.initials: M
authors.lastname: Yamauchi
authors.forename: T
authors.initials: T
authors.lastname: Kitano
authors.forename: T
authors.initials: T
authors.lastname: Itohara
authors.forename: Y
authors.initials: Y
authors.lastname: Nohno
authors.forename: K
authors.initials: K
authors.lastname: Nakayama
mesh_terms: D000368:Aged; D001022:Aortic Valve Insufficiency / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000601:surgery; D005260:Female; D006346:Heart Septum / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D011475:Prosthesis Failure; D012086:Reoperation; D016896:Treatment Outcome