title: A modified Park's stitch to correct aortic insufficiency for bioprosthetic valve at time of left ventricular assist device implant: a case report.
abstract: BACKGROUND
  Aortic valve insufficiency (AI) at the time of left ventricular assist device (LVAD) insertion needs to be corrected, however there is little known about how to manage bioprosthetic valvular AI.
  
  
  METHODS
  A 55-year-old female with dilated cardiomyopathy who previously had a bioprosthetic aortic valve replacement needed a LVAD as a bridge to transplant. Her left ventricular ejection fraction was 10% and had mild to moderate transvalvular AI. She underwent a HeartWare HVAD insertion along with aortic valvular coaptation stitch repair (Park's stitch) to the bioprosthetic valve.
  
  
  CONCLUSIONS
  Her AI improved to trivial with minimal ejection through the bioprosthetic valve. She was transplanted 6 months following the surgery. A Park's stitch to the bioprosthetic aortic valve with more than mild AI might be a good option for bridge to transplant patient.
authors.affiliation: Division of Cardiothoracic Surgery, The University of Arizona/ Banner University Medical Center Tucson, 1501 N Campbell Ave., Rm 4302A, P.O. Box 245071, Tucson, AZ, 85724-5071, USA.
authors.forename: Toshinobu
authors.initials: T
authors.lastname: Kazui
authors.affiliation: Division of Cardiothoracic Surgery, The University of Arizona/ Banner University Medical Center Tucson, 1501 N Campbell Ave., Rm 4302A, P.O. Box 245071, Tucson, AZ, 85724-5071, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Sydow
authors.affiliation: Division of Cardiology, The University of Arizona/ Banner University Medical Center Tucson, Tucson, AZ, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Friedman
authors.affiliation: Division of Cardiothoracic Surgery, The University of Arizona/ Banner University Medical Center Tucson, 1501 N Campbell Ave., Rm 4302A, P.O. Box 245071, Tucson, AZ, 85724-5071, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Kim
authors.affiliation: Division of Cardiothoracic Surgery, The University of Arizona/ Banner University Medical Center Tucson, 1501 N Campbell Ave., Rm 4302A, P.O. Box 245071, Tucson, AZ, 85724-5071, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Lick
authors.affiliation: Division of Cardiothoracic Surgery, The University of Arizona/ Banner University Medical Center Tucson, 1501 N Campbell Ave., Rm 4302A, P.O. Box 245071, Tucson, AZ, 85724-5071, USA. zkhalpey@surgery.arizona.edu.
authors.forename: Zain
authors.initials: Z
authors.lastname: Khalpey
mesh_terms: D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000601:surgery*; D001705:Bioprosthesis / Q000009:adverse effects*; D002311:Cardiomyopathy, Dilated / Q000150:complications / Q000601:surgery; D005260:Female; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006353:Heart-Assist Devices; D006801:Humans; D008875:Middle Aged; D019919:Prosthesis Implantation; D013536:Suture Techniques
keywords: Aortic insufficiency; Aortic valve repair; Bioprosthetic valve; Left ventricular assist device; Park’s stitch