title: Repair of intervalvular fibrous body rupture during aortic valve replacement.
abstract: The intervalvular fibrosa, the structure that connects the mitral and the aortic valves, can be injured during aortic valve replacement. Although this complication is rare, it may require complex and extensive repair. Herein, we describe management of a damaged aortic-mitral curtain and fibrous body during tissue aortic valve replacement in a patient with mixed connective tissue disorder. A "U" suture repair combining an external and internal reinforcement repair technique via the aorta, without explanting the prosthetic valve technique, is described. The purpose of using the "externalized" buttressed U-stitch was to obliterate any residual cavity and to assure control of hemorrhage externally. Repair of damaged fibrous body during aortic valve replacement (AVR) is challenging. We managed this difficult situation in a satisfactory surgical approach without explanting the aortic prosthesis.
authors.affiliation: Division of Cardiac Surgery, Baystate Medical Center, Springfield, Massachusetts 01107, USA. akalameddine@gmail.com
authors.forename: Abdallah K
authors.initials: AK
authors.lastname: Alameddine
authors.forename: Victor K
authors.initials: VK
authors.lastname: Alimov
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Flack
mesh_terms: D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D003238:Connective Tissue / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D012086:Reoperation; D013536:Suture Techniques; D014463:Ultrasonography