title: Dehiscence of a pulmonary bioprosthesis with a focal dissection of the pulmonary artery in a patient with congenital pulmonic stenosis.
abstract: Pulmonary valve replacement (PVR) is the most common adult congenital cardiac operation performed. Valve degeneration leading to prosthetic stenosis and/or regurgitation is a long-term risk in this population and may be associated with paravalvular leak (PVL). Complications involving the proximal pulmonary artery, including dissection, are less clearly defined. Herein, we report the case of a 30-year-old patient with a history of multiple pulmonary valve interventions secondary to congenital pulmonic stenosis, who developed dehiscence of a bioprosthetic PVR associated with significant paravalvular leak (PVL) and further complicated by a focal dissection of the proximal pulmonary artery.
authors.affiliation: Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Evin
authors.identifier: http://orcid.org/0000-0002-7074-6380
authors.initials: E
authors.lastname: Yucel
authors.affiliation: Adult Congenital Heart Disease Program, Massachusetts General Hospital, Division of Cardiology, Harvard Medical School, Boston, MA, USA.
authors.forename: Ami
authors.initials: A
authors.lastname: Bhatt
authors.affiliation: Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Christos G
authors.initials: CG
authors.lastname: Mihos
authors.affiliation: Cardiac MR PET CT Program, Massachusetts General Hospital, Department of Radiology and Division of Cardiology, Harvard Medical School, Boston, MA, USA.
authors.forename: Brian B
authors.initials: BB
authors.lastname: Ghoshhajra
authors.affiliation: Cardiac Ultrasound Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.|Adult Congenital Heart Disease Program, Massachusetts General Hospital, Division of Cardiology, Harvard Medical School, Boston, MA, USA.
authors.forename: Doreen
authors.initials: D
authors.lastname: DeFaria Yeh
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000000981:diagnostic imaging; D001705:Bioprosthesis / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000379:methods; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D011666:Pulmonary Valve Stenosis / Q000150:complications* / Q000601:surgery*; D000071079:Stenosis, Pulmonary Artery / Q000150:complications / Q000151:congenital* / Q000000981:diagnostic imaging; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology*
keywords: bioprosthetic pulmonary valve replacement; congenital heart disease; echocardiography; paravalvular regurgitation; pulmonary artery dissection; pulmonic stenosis