title: Commissural detachment and Valsalva sinus dilatation after implantation of Prima Plus stentless valve with full root technique.
abstract: The stentless aortic bioprosthesis has been used because of its excellent hemodynamics and few valve-related complications. We report a case of redo aortic root replacement for severe aortic regurgitation and dilatation of the Valsalva sinus 7 years after the implantation of a Prima Plus aortic root bioprosthesis (Edwards LifeScience, Irvine, CA, USA) using a full root technique. Intraoperative findings showed the complete detachment of the commissure between the left and non-coronary cusps, and Valsalva sinus dilatation of the porcine aortic root bioprosthesis. Redo aortic root replacement with a 23-mm porcine bioprosthesis and 28-mm straight graft was performed. There were no findings of intimal tear, suture dehiscence, degeneration, and perforation of the bioprosthesis. Such complications associated with the Edwards Prima Plus aortic root bioprosthesis were rarely reported. Commissural detachment of a porcine stentless aortic bioprosthesis can occur; thus, careful follow-up involving echocardiography and computed tomography is necessary.
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan. s-ohira@koto.kpu-m.ac.jp.
authors.forename: Suguru
authors.initials: S
authors.lastname: Ohira
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Doi
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Okawa
authors.affiliation: Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
mesh_terms: D000818:Animals; D001011:Aorta / Q000601:surgery; D001018:Aortic Diseases / Q000473:pathology / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000601:surgery*; D001705:Bioprosthesis; D004108:Dilatation, Pathologic / Q000473:pathology / Q000601:surgery; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D011475:Prosthesis Failure / Q000209:etiology; D012086:Reoperation; D012850:Sinus of Valsalva / Q000601:surgery; D013552:Swine
keywords: Commissural detachment; Root dilatation; Stentless aortic bioprosthesis