title: A Late Sequela of the David Procedure: Left Main Coronary Artery Compression and Myocardial Infarction due to Pseudoaneurysm Formation.
abstract: Valve-sparing root replacement (the David procedure) is a valuable alternative to conventional aortic root replacement with a composite graft, especially in patients whose aortic valve leaflets have not been altered. However, reintervention rates are higher than are those associated with composite graft implantation. In this report, we present the case of a patient who had undergone valve-sparing root replacement 2 years earlier and was admitted to our hospital with myocardial infarction and cardiogenic shock secondary to coronary ostial button dissection, aortic pseudoaneurysm formation, and severe left main coronary artery compression. To our knowledge, this case is exceedingly rare. Rather than attempt local reconstruction of the mouth of the pseudoaneurysm, we excised the lesion, the aortic valve, and the graft, and we successfully implanted a composite aortic graft with a mechanical aortic valve.
authors.forename: Mehmet Baran
authors.initials: MB
authors.lastname: Karatas
authors.forename: Abdullah Kemal
authors.initials: AK
authors.lastname: Tuygun
authors.forename: Baris
authors.initials: B
authors.lastname: Gungor
authors.forename: Seviye Bora
authors.initials: SB
authors.lastname: Sisman
authors.forename: Sinan
authors.initials: S
authors.lastname: Sahin
authors.forename: Osman
authors.initials: O
authors.lastname: Bolca
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001705:Bioprosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003323:Coronary Aneurysm / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014057:Tomography, X-Ray Computed
keywords: Aneurysm, false; aorta; left main coronary artery; male; myocardial infarction; reoperation