title: Reoperation for mid-term failure of a freestyle bioprosthesis using a full root technique --a surgical case--.
abstract: The aortic root of a 30-year-old man was replaced with a Freestyle stentless aortic bioprosthesis for aortic regurgitation associated with annuloaortic ectasia. His clinical course was uneventful, and he was discharged without complications. Three years and six months after surgery, he presented with a high fever. Four years after surgery, transthoracic echocardiography revealed severe aortic regurgitation. We performed exploratory surgery and discovered a torn left coronary cusp of the Freestyle bioprosthesis. Organized vegetation was adherent to the left coronary cusp leaflet. The non-coronary cusp and the right coronary cusp were normal. The diagnosis was aortic regurgitation due to valve failure related to infective endocarditis. Consequently, we reconstructed the aortic root with a composite graft (26-mm Valsalva graft and a 21-mm ON-X mechanical valve).
authors.affiliation: Department of Cardiovascular Surgery, Shin Tokyo Hospital, Matsudo, Chiba, Japan. nakamurakin-ths@umin.ac.jp
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Nakamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakao
authors.forename: Yu
authors.initials: Y
authors.lastname: Oshima
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Tokunaga
authors.forename: Mikiko
authors.initials: M
authors.lastname: Murakami
authors.forename: Shinichi
authors.initials: S
authors.lastname: Mitsuyama
mesh_terms: D000328:Adult; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D013291:Streptococcus / Q000302:isolation & purification; D013997:Time Factors; D016896:Treatment Outcome