Pseudoaneurysm of ascending aorta combined with aortic valve infective endocarditis after cardiac operations for congenital ventricular septal defect

Aortic valve regurgitation caused by a leaflet perforation occurs most often with infective endocarditis involving the aortic valve. Although rare, leaflet perforation can be caused by suture-related injury during cardiac operations, such as mitral valve replacement, ventricular septal defect (VSD) repair, and repair of an ostium primum atrial septal defect. Few reports have described this form of iatrogenic aortic valve leaflet perforation. We used a pericardial patch in a successful repair of an iatrogenic perforation in an aortic valve leaflet that occurred after simple VSD repair.

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Pseudoaneurysm of the Ascending Aorta Combined with Aortic Valve Infective Endocarditis following Cardiac Operations

The Heart Surgery Forum ◽

10.1532/hsf98.20101103 ◽

2011 ◽

Vol 14 (1) ◽

pp. 70

Author(s):

Shengli Jiang ◽

Tao Zhang ◽

Bojun Li ◽

Chonglei Rei ◽

Tingting Chen ◽

...

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Circulatory Arrest ◽

Ascending Aorta ◽

Hypothermic Circulatory Arrest ◽

Mechanical Prosthesis ◽

Computed Tomographic ◽

Life Threatening ◽

Femorofemoral Bypass ◽

Cardiac Operations

Background and Objective: Aortic pseudoaneurysms are rare but life-threatening complications of aortic procedures. Operation on the femorofemoral bypass with hypothermic circulatory arrest has been the method of choice. Iatrogenic ascending aorta pseudoaneurysm combined with infective endocarditis of the aortic valve has never been reported.Materials and Methods: We describe a case of a pseudoaneurysm of the ascending aorta at the site of an aortotomy site concomitant with infective endocarditis of the aortic valve. A contrast computed tomographic scan was the investigation technology of choice.Results: The operation was performed on femorofemoral bypass without hypothermic circulatory arrest, which provided safe re-entry and an opportunity to replace the infected aortic valve with a mechanical prosthesis and to repair the aortic defect with a patch.Conclusions: The ascending aorta pseudoaneurysm can be safely operated on with femorofemoral bypass without hypothermic cardiac arrest.

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‘Absent pulmonary valve’ syndrome associated with muscular ventricular septal defect and aneurysmal dilation of the ascending aorta

Cardiology in the Young ◽

10.1017/s1047951100002183 ◽

1994 ◽

Vol 4 (2) ◽

pp. 184-186 ◽

Cited By ~ 1

Author(s):

Dennis Kececioglu ◽

Omar Galal ◽

Fuad Abbag

Keyword(s):

Aortic Valve ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Pulmonary Valve ◽

Ascending Aorta ◽

Absent Pulmonary Valve ◽

Rare Association ◽

Muscular Ventricular Septal Defect ◽

Aneurysmal Dilation ◽

Absent Pulmonary Valve Syndrome

SummaryA rare association of ‘absent pulmonary valve’ syndrome, midmuscular ventricular septal defect and aneurysmatic dilation of the ascending aorta without pathology of the aortic valve is described in a 10-month-old infant. The diagnosis was established by echocardiography and angiography.

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A Case of Unicuspid Aortic Valve Associated with a Single Coronary Artery and Ventricular Septal Defect

Choonpa Igaku ◽

10.3179/jjmu.33.75 ◽

2006 ◽

Vol 33 (1) ◽

pp. 75-81

Author(s):

Hiroko ISHIGAMI ◽

Masatsugu IWASE ◽

Keiko HYOUDO ◽

Idumi AOYAMA ◽

Mamoru ITO ◽

...

Keyword(s):

Coronary Artery ◽

Aortic Valve ◽

Ventricular Septal Defect ◽

Septal Defect ◽

Single Coronary Artery

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More in, better out? Successful valve-in-valve procedure of an iatrogenic ventricular septal defect following transcatheter aortic valve replacement: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab097 ◽

2021 ◽

Vol 5 (5) ◽

Author(s):

Klaus-Dieter Hönemann ◽

Steffen Hofmann ◽

Frank Ritter ◽

Gerold Mönnig

Keyword(s):

Aortic Valve ◽

Ventricular Septal Defect ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Transcatheter Aortic Valve Replacement ◽

Septal Defect ◽

Left Ventricular ◽

Heart Team ◽

Transcatheter Aortic Valve ◽

Valve In Valve

Abstract Background A rare, but serious, complication following transcatheter aortic valve replacement (TAVR) is the occurrence of an iatrogenic ventricular septal defect (VSD). Case summary We describe a case of an 80-year-old female who was referred with severe aortic stenosis for TAVR. Following thorough evaluation, the heart team consensus was to proceed with implantation via a transapical approach of an ACURATE neo M 25 mm valve (Boston Scientific, Natick, MA, USA). The valve was deployed harnessing transoesophageal echocardiographic (TOE) guidance under rapid pacing with post-dilation. Directly afterwards a very high VSD close to the aortic annulus was detected. As the patient was haemodynamically stable, the procedure was ended. The next day another TOE revealed a shunt volume (left-to-right ventricle) between 50% and 60%. Because the defect was partly located between the stent struts of the ACURATE valve decision was made to fix this leakage with implantation of a further valve and we chose an EVOLUT Pro 29 mm (Medtronic Inc., Minneapolis, MN, USA). The valve-in-valve was implanted 2–3 mm below the lower edge of the first valve, more towards the left ventricular outflow tract (LVOT) with excellent result: VSD was reduced to a very small residual shunt without any hemodynamic relevance. Discussion We suggest that an iatrogenic VSD located near the annulus may be treated percutaneously in a bail-out situation with implantation of a second valve that should be implanted slightly more into the LVOT to cover the VSD.

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