title: Repair of bicuspid aortic valve in the presence of endocarditis and leaflet perforation.
abstract: Aortic valve repair can be a good option in younger patients who have severe aortic regurgitation. A systematic, disease-directed approach can simplify repair. This case report describes how a simplified approach can be successfully applied to complex pathologic conditions of the aortic valve. A 49-year-old man with a bicuspid aortic valve and a history of endocarditis presented with severe aortic regurgitation and evidence of recurrent infection. Intraoperatively, we found congenital and degenerative aortic anatomy with endocarditis and perforation. We performed aortic valve repair to enable leaflet coaptation and to adjust the coaptation height. After 24 months, the patient remained well, with an intact repair and trivial aortic regurgitation. We describe our systematic repair approach and rationales for targeting repairs to identified lesions. To our knowledge, this is the first description of complex aortic valve repairs in a patient who had simultaneous congenital, degenerative, and infectious conditions.
authors: Division of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta T2N 2T9, Canada.
authors: William D T
authors: WD
authors: Kent
authors: Hadi D
authors: HD
authors: Toeg
authors: Jehangir J
authors: JJ
authors: Appoo
mesh_terms: D001021:Aortic Valve / Q000002:abnormalities* / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D006348:Cardiac Surgical Procedures; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006349:Heart Valve Diseases / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013290:Streptococcal Infections / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D034363:Viridans Streptococci / Q000302:isolation & purification*