title: Transecting the aorta to close the aortic prosthetic valve paravalvular space.
abstract: The residual aortic prosthetic valve paravalvular space beneath the left coronary artery is very difficult and risky to repair. To improve visualization of this area, we transected the ascending aorta and mobilized both the aortic root and the left coronary artery from the surrounding tissue. Subsequently, we retracted the left coronary artery aside and pulled the posterior aortic root upwards. This maneuver has provided enough space for the safe placement of stitches and the closure of the paraprosthetic defect in this very delicate area.
authors.affiliation: Department of Cardiac Surgery, Institute for Cardiovascular Disease DEDINJE," Belgrade, Serbia. stojivan@eunet.yu
authors.forename: Ivan C
authors.initials: IC
authors.lastname: Stojanovic
authors.forename: Petar A
authors.initials: PA
authors.lastname: Milacic
authors.forename: Sinisa P
authors.initials: SP
authors.lastname: Jagodic
authors.forename: Ljiljana I
authors.initials: LI
authors.lastname: Jovovic
authors.forename: Miroslava G
authors.initials: MG
authors.lastname: Gojnic
authors.forename: Bosko P
authors.initials: BP
authors.lastname: Djukanovic
mesh_terms: D001013:Aorta, Thoracic / Q000601:surgery*; D001021:Aortic Valve / Q000382:microbiology / Q000601:surgery; D001705:Bioprosthesis; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000382:microbiology / Q000601:surgery; D017755:Prosthesis Fitting / Q000379:methods; D018570:Risk Assessment; D013536:Suture Techniques; D016896:Treatment Outcome