scholarly journals Surgical management of extensive aortic root endocarditis with ventricular septal rupture: A case report

2021 ◽  
Author(s):  
Satoru Maeba ◽  
Dai Kawashima ◽  
Masahiro Saito ◽  
Ryoi Okano ◽  
Masatoshi Sunada ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Ventricular Septum ◽  
Ventricular Septal Rupture ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Cardiac Decompensation ◽  
Post Surgery ◽  
Extensive Debridement ◽  
Severe Pulmonary Edema

A 79-year-old man was referred for severe cardiac decompensation. Chest radiography showed severe pulmonary edema, and transesophageal echocardiography revealed a large quantity of vegetation on all aortic valve leaflets with severe aortic valve regurgitation, heterogeneous cavities adjacent to the aortic annulus, and ventricular septal rupture. We performed thorough and extensive debridement of the aortic root; including the infected ventricular septum, reconstructed the ventricular septum and aortic root using autologous and bovine pericardial patches; and placed a bioprosthetic stented valve. The patient was discharged without any complications, and without recurrence of the endocarditis in the four years post-surgery.

Residual aortic valve regurgitation after aortic root remodeling without a direct annuloplasty

1998 ◽  
Vol 66 (4) ◽  
pp. 1269-1272 ◽  
Author(s):  
Carlo Bassano ◽  
Ruggero De Paulis ◽  
Alfonso Penta de Peppo ◽  
Antonio Tondo ◽  
Laura Fratticci ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Aortic Root Remodeling

Valve-sparing aortic root replacement after type A aortic dissection repairs

2020 ◽  
pp. 021849232097798
Author(s):  
Noriyuki Abe ◽  
Kenji Okada ◽  
Hiroshi Tanaka ◽  
Yutaka Okita
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Aortic Root Replacement ◽  
Moderate Degree ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Proximal Anastomosis ◽  
Aortic Cusp ◽  
Valve Sparing

Objective Aortic root reoperation after aortic dissection repair sometimes requires aortic root replacement. A valve-preserving technique should be applied when the aortic cusp is normal. Valve-sparing aortic root reconstruction using the reimplantation technique resolves aortic valve regurgitation, root dilatation, and pseudoaneurysm in the proximal anastomosis. Our experience in aortic root reoperation is presented. Methods From January 2000 to March 2019, 26 patients underwent reoperative valve-sparing aortic root reconstruction using the reimplantation technique. The time from the initial operation to reoperation was 69.3 ± 51.6 months. Aortic root reoperation was required for a fragile wall at the previous proximal anastomosis or aortic root dilatation. We aimed to stabilize the aortic root without valve regurgitation. The native aortic cusp was aggressively preserved when nearly normal. Indications included root dilatation ( n = 13), pseudoaneurysm of the previous proximal anastomosis ( n = 11), and aortic valve regurgitation ( n = 4). Results There was no early postoperative mortality. Follow-up was 49 ± 47 months (range 4–161 months). The 3, 5, and 10-year survival was 88.9% ± 7.4%, 88.9% ± 7.4%, and 77.8% ± 12.2%, respectively. Freedom from recurrence of a greater than moderate degree of aortic valve regurgitation at 3, 5, and 10 years was 86.5% ± 8.9%, 86.5% ± 8.9%, and 86.5% ± 8.9%, respectively. One patient underwent aortic valve replacement for recurrent aortic valve regurgitation 15 months after the valve-sparing reoperation. Conclusions Midterm outcomes of reoperative valve-sparing aortic root reconstruction using the reimplantation technique and postoperative aortic valve performance were satisfactory.

scholarly journals Aortitis as a Rare Cause of Aortic Aneurysm and Valve Regurgitation: Is Repair Precluded?

2018 ◽  
Vol 2018 ◽  
pp. 1-2
Author(s):  
Carlos Porras ◽  
Gemma Sanchez-Espin ◽  
Miguel Such ◽  
Jesús Sánchez-Ramos ◽  
Alicia Bautista-Pavés ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Root ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Aortic Root Aneurysm ◽  
Aortic Root Dilatation ◽  
Valve Sparing

Aortitis is an infrequent cause of aortic root dilatation and aortic valve regurgitation. Valve-sparing procedures have been proposed, but there is not clear evidence of which is the treatment of choice. We report the case of a 38-year-old pregnant lady with a diagnosis of idiopathic aortitis associated with aortic root aneurysm and severe aortic valve regurgitation.

scholarly journals Aortic root diameter is associated with HLA-B27: identifying the patient with ankylosing spondylitis at risk for aortic valve regurgitation

2021 ◽  
Author(s):  
M. Baniaamam ◽  
S. C. Heslinga ◽  
T. C. Konings ◽  
M. L. Handoko ◽  
O. Kamp ◽  
...  
Keyword(s):  
Ankylosing Spondylitis ◽  
Aortic Valve ◽  
Aortic Root ◽  
Root Diameter ◽  
Hla B27 ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Elderly Male ◽  
Cross Sectional ◽  
Color Flow

AbstractTo assess the association between the aortic root diameter in HLA-B27 positive (+) and HLA-B27 negative (−) ankylosing spondylitis (AS) patients from the CARDAS cohort. The CARDAS study is a cross-sectional study in AS patients between 50 and 75 years who were recruited from a large rheumatology outpatient clinic. Patients underwent cardiovascular screening including echocardiography, with 2D, spectral, and color flow Doppler measurements. The aortic root was measured at sinuses of Valsalva during diastole. The aortic root diameter was adjusted for body surface area (BSA) (aortic root index, cm/m2). 193 Consecutive AS patients were included of whom 158 (82%) were HLA-B27 positive. The aortic root index was significantly higher in HLA-B27 + patients compared to HLA-B27− patients, respectively, 1.76 cm ± 0.21 vs. 1.64 cm ± 0.14, p < 0.001. No difference was seen in the prevalence of aortic valve regurgitation (AVR), p = 0.8. Regression analysis showed a significant association between HLA-B27 and aortic root index corrected for age, sex and cardiovascular risk factors (β 0.091, 95% CI 0.015–0.168, p = 0.02). Especially, male HLA-B27 + patients had a significantly increased aortic root index compared to male HLA-B27− AS patients, respectively, 1.76 cm (1.63–1.88) and 1.59 cm (1.53–1.68), p < 0.001. We found an increased aortic root index in elderly HLA-B27 + AS patients compared to HLA-B27− AS patients, especially in male patients. No difference was seen in the prevalence of AVR. However, as AVR can be progressive, echocardiographic monitoring in elderly male HLA-B27 + AS might be considered.

scholarly journals MANAGEMENT OF AORTIC ROOT ABSCESS DUE TO VALVE ENDOCARDITIS: A FORMIDABLE SURGICAL CHALLENGE

2020 ◽  
pp. 1-4
Author(s):  
Pradeep Kumar Radhakrishnan ◽  
Gayathri Ananyajyothi Ambat ◽  
Nihas Nazer ◽  
Y A Nazer
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Root ◽  
Cardiac Tissue ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Tissue Destruction ◽  
Free Communication ◽  
General Terms ◽  
Aortic Root Abscess

Aortic root abscess results when uncontrolled infective endocarditis causes aneurysm of one of the sinuses of Valsalva that is in free communication with the aortic root above the valve cusps. The risk factors for aortic root abscess in endocarditis are bicuspid aortic valve, aortic valve regurgitation, degenerative aortic stenosis and patients with multi valvular disease. In general terms, prognosis is better if surgery is undertaken early, before cardiac tissue destruction and deterioration in the overall condition of the patient increase the hazards of intervention.

scholarly journals Progression of aortic root dilatation and aortic valve regurgitation after the arterial switch operation

Heart ◽  
2019 ◽  
Vol 105 (22) ◽  
pp. 1732-1740 ◽  
Author(s):  
Roel L F van der Palen ◽  
Teun van der Bom ◽  
Annika Dekker ◽  
Roula Tsonaka ◽  
Nan van Geloven ◽  
...  
Keyword(s):  
Risk Factors ◽  
Aortic Valve ◽  
Aortic Root ◽  
Arterial Switch Operation ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Sinotubular Junction ◽  
Switch Operation ◽  
Over Time ◽  
Aortic Dimensions

ObjectiveTo study neo-aortic growth and the evolution of neo-aortic valve regurgitation (AR) in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) from newborn to adulthood and to identify patients at risk.MethodsNeo-aortic dimensions (annulus/root/sinotubular junction) and neo-aortic valve regurgitation were assessed serially in 345 patients with TGA who underwent ASO between 1977 and 2015. Linear mixed-effect models were used to assess increase of neo-aortic dimensions over time and to identify risk factors for dilatation. Risk factor analysis for AR by using time-dependent Cox regression models.ResultsAfter a rapid increase in the first year after ASO and proportional growth in childhood, neo-aortic dimensions continue to increase in adulthood without stabilisation. Annual diameter increase in adulthood was 0.39±0.06, 0.63±0.09 and 0.54±0.11 mm for, respectively, neo-aortic annulus, root and sinotubular junction, all significantly exceeding normal growth. AR continues to develop over time: freedom from AR ≥moderate during the first 25 years post-ASO was 69%. Risk factors for root dilatation were complex TGA anatomy (TGA-ventricular septal defect (VSD), double outlet right ventricle with subpulmonary VSD) and male gender. Risk factors for AR ≥moderate were: complex TGA anatomy and neo-aortic growth. Per millimetre increase in aortic root dimension, there was a 9% increase in the hazard of AR ≥moderate. Bicuspid pulmonary valve did not relate to the presence of root dilatation or AR.ConclusionAfter ASO, neo-aortic dilatation proceeds beyond childhood and is associated with an increase in AR incidence over time. Careful follow-up of the neo-aortic valve and root function is mandatory, especially in males and in patients with complex TGA anatomy.

scholarly journals Aortic valve replacement due to granulomatosis with polyangiitis: a case series

2020 ◽  
Vol 4 (5) ◽  
pp. 1-6
Author(s):  
Gilles Uijtterhaegen ◽  
Laura De Donder ◽  
Eline Ameloot ◽  
Kristof Lefebvre ◽  
Jo Van Dorpe ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infective Endocarditis ◽  
Aortic Valve ◽  
Valve Replacement ◽  
Valvular Heart Disease ◽  
Granulomatosis With Polyangiitis ◽  
Surrounding Tissue ◽  
Valve Regurgitation ◽  
Aortic Valve Regurgitation ◽  
Severe Aortic Regurgitation

Abstract Background Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a systemic inflammatory process predominantly affecting upper and lower respiratory tract and kidneys. Valvular heart disease is a rare manifestation of GPA. Case summary We report two cases of acute valvular heart disease mimicking acute endocarditis caused by GPA. Both patients were middle-aged females with acute aortic valve regurgitation suggestive of possible infective endocarditis. In their recent medical history, atypical otitis and sinusitis were noted. The first patient was admitted with heart failure and the second patient because of persisting fever. Echocardiogram revealed severe aortic regurgitation with an additional structure on two cusps, suggestive of infective endocarditis in both patients. Urgent surgical replacement was performed; however, intraoperative findings did not show infective endocarditis, but severe inflammatory changes of the valve and surrounding tissue. In both patients, the valve was replaced by a prosthetic valve. Microscopic examination of the valve/myocardial biopsy showed diffuse acute and chronic inflammation with necrosis and necrotizing granulomas, compatible with GPA after infectious causes were excluded. Disease remission was obtained in both patients, in one patient with Rituximab and in the other with Glucocorticoids and Cyclophosphamide. Both had an uneventful follow-up. Discussion Granulomatosis with polyangiitis can be a rare cause of acute aortic valve regurgitation mimicking infective endocarditis with the need for surgical valve replacement. Atypical ear, nose, and throat symptoms can be a first sign of GPA. Symptom recognition is important for early diagnosis and appropriate treatment to prevent further progression of the disease.

Sign in / Sign up

Export Citation Format

Share Document