scholarly journals Extensive calcification of the interventricular septum with caseous cavity deriving from stenotic aortic valve

Cor et Vasa ◽  
2021 ◽  
Vol 63 (6) ◽  
pp. 743-743
Author(s):  
Branislav Bezák ◽  
Panagiotis Artemiou ◽  
Juraj Grebáč ◽  
Dávid Kocan ◽  
Michal Hulman
Keyword(s):  
Aortic Valve ◽  
Interventricular Septum ◽  
Extensive Calcification

Interventricular septum aneurysm: Two differently managed cases and association with bicuspid aortic valve

2015 ◽  
Vol 201 ◽  
pp. 438-440
Author(s):  
Alexandru Deaconu ◽  
Silvia Iancovici ◽  
Ernst Wellnhofer ◽  
Alexander Berger ◽  
Rolf Gebker ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Interventricular Septum

scholarly journals Application of the Konno procedure for infective endocarditis in native bicuspid aortic valve with annular abscess extending into the interventricular septum

2021 ◽  
Vol 2021 (9) ◽  
Author(s):  
Toshio Doi ◽  
Kanetsugu Nagao ◽  
Hayato Obi ◽  
Akihiko Higashida ◽  
Masaya Aoki ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Interventricular Septum ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Left Ventricular Outflow ◽  
Surgical Field ◽  
Annular Abscess ◽  
Complex Surgery ◽  
Septal Abscess

Abstract Annular abscess is a serious complication of infective endocarditis, which often requires complex surgery and has a very high post-operative mortality rate. The Konno procedure involves valve annuloplasty for a narrow aortic annulus or left ventricular outflow tract stenosis in children; it is also performed for various cardiac conditions in adults. Here, we report a case of the Konno procedure performed in a patient with aortic valve infective endocarditis, with an annular abscess extending into the interventricular septum (IVS). A 58-year-old man who presented to our hospital with fever was diagnosed with aortic valve infective endocarditis caused by Streptococcus saccharolyticus. On echocardiography, an annular abscess in the direction of the IVS was detected, and surgery was planned. The Konno procedure was performed to secure an adequate surgical field and to debride and reconstruct the cavity created by the interventricular septal abscess. The patient was discharged uneventfully 29 days after surgery.

scholarly journals P1321 A case of multiple levels of ventricular obstruction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Oikonomidis ◽  
A Klitirinos ◽  
M Koutouzis ◽  
A Kalangos ◽  
E Lazaris ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Mitral Valve ◽  
Aortic Valve ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Imaging Modalities ◽  
Subaortic Stenosis ◽  
Shortness Of Breath ◽  
Septal Myectomy ◽  
Subaortic Membrane

Abstract Subaortic stenosis (SAS) is a rare entity in adults with unclear etiology and variable presentation. SAS may be presented with symptoms mimicking Hypertrophic Cardiomyopathy (HCM). Often a combination of imaging modalities is needed to distinguish SAS from HCM with obstruction. A 53 years old man, smoker, was referred to our medical center suffering from shortness of breath on exertion. He first presented at another facility with a 2 month history of shortness of breath and chest discomfort during brisk physical activity and the possible diagnosis of HCM was made. On physical examination, a 3/6 systolic murmur was audible along the left sternal border, that became louder with standing and the Valsalva maneuver. The patient had non distended jugular veins, clear lung fields and no ankle edema. The results of laboratory exams did not reveal any pathological sign. The transthoracic echocardiogram revealed significant left ventricular hypertrophy (Interventricular septum 21 mm, Posterior wall 16 mm) with normal left ventricular systolic performance (ejection fraction >70%). The aortic valve was tricuspid and calcified whereas mitral valve was morphologically normal, with systolic anterior motion and mild posterolaterally directed regurgitation. Two systolic gradients, one dynamic, late peaking of 85mmHg and another fixed of 70mmHg were detected in left ventricular outflow track (LVOT). Transesophageal echocardiography was performed for the better evaluation of aortic valve and showed a three level obstruction caused by the systolic motion of the mitral valve towards the hypertrophic septum at LVOT, the presence of a membranous subaortic membrane and the calcified aortic valve respectively. The aortic valve was calcified with a moderate stenosis (0.8cm2 / m2) from 3D planimetry. A Cardiac Magnetic Resonance exam was ordered and confirmed the significance of hypertrophy and the presence of circumferential subaortic membrane. No late enhancement after the administration of Gadolinium was observed. Coronary angiography was performed and demonstrated normal coronary arteries. We hypothesized that the presence of subaortic membrane led to marked myocardial wall thickness and to the destruction of the aortic valve due to turbulent flow in the LVOT. The patient was referred for surgical management Extended septal myectomy combined with complete resection of orbital subaortic membrane were performed. he calcified aortic valve was replaced by bioprosthetic valve No 23mm. The patient tolerated the procedure well with significant symptomatic improvement. TTE performed 1 month postoperatively showed no remarkable LVOT gradient. The results of histopathology and genes investigations are pending. Subaortic membrane is a rare cause of symptoms that can mimic hypertrophic cardiomyopathy. A combination of imaging modalities is needed to distinguish subaortic stenosis from aortic valve stenosis and hypertrophic obstructive cardiomyopathy. Abstract P1321 Figure. Three levels obstruction

scholarly journals A case report: a rare case of severe aortic incompetence

2020 ◽  
Vol 4 (3) ◽  
pp. 1-5
Author(s):  
Mandeep Singh Sondh ◽  
Rohit Tandon ◽  
Rajiv Gupta ◽  
Gurpreet Singh Wander
Keyword(s):  
Aortic Valve ◽  
Rare Case ◽  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Interventricular Septum ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Valve Prosthesis ◽  
Aortic Incompetence ◽  
The Right

Abstract Background Aneurysms of the sinus of Valsalva (SOV) are thin-walled outpouchings most commonly involving the right or non-coronary sinuses. Because they are asymptomatic, they are rarely discovered before they rupture and form an aorto-cardiac fistula. We present a rare case of unruptured aneurysm of the right coronary SOV burrowing into the interventricular septum with severe aortic incompetence and left ventricular dysfunction. To our knowledge, burrowing of the SOV aneurysm (SVA) into the interventricular septum and its large sac-like appearance has never been described using three dimensional (3D) echocardiography before. Case summary A 37-year-old man presented to the cardiology outpatient department with complaints of dyspnoea and palpitations (New York Heart Association Class II–III) for the last 6 months. He was evaluated with transthoracic echocardiography which showed a large mobile sac-like structure with irregular borders bulging and prolapsing into the left ventricular cavity with each cardiac cycle along with severe aortic incompetence. On transoesophageal echocardiogram, the right coronary cusp showed malcoaptation with deformed aortic sinus causing severe aortic incompetence. Cardiac computed tomography showed sparing of right coronary artery at the origin. A diagnosis of SVA was made. The patient underwent aortic valve replacement along with partial resection of the aneurysm. The patient had an uneventful postoperative course. Follow-up echocardiography after 4 weeks showed well-seated aortic valve prosthesis with residual SVA. The ejection fraction decreased from 46–48% to 36–38%. Discussion Comprehensive multimodality imaging can be used for management strategy of SVA.

scholarly journals Approach to the interventricular septum with transection and restoration of the fibrous ring of aortic valve (experimental study)

2021 ◽  
Vol 36 (1) ◽  
pp. 134-140
Author(s):  
A. V. Gurshchenkov ◽  
Ya. A. Dyachenko ◽  
A. D. Maystrenko ◽  
V. E. Uspensky ◽  
A. N. Ibragimov ◽  
...  
Keyword(s):  
Experimental Study ◽  
Aortic Valve ◽  
Interventricular Septum

P3697A reappraisal of bioprosthetic aortic valve failure related to structural valve degeneration

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Le Tourneau ◽  
C Cueff ◽  
L Guerma ◽  
G Guimbretiere ◽  
N Piriou ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Current Practice ◽  
Nyha Class ◽  
Major Complication ◽  
Clinical Work ◽  
Diuretic Treatment ◽  
Mean Delay ◽  
Extensive Calcification ◽  
Calcification Process ◽  
Work Up

Abstract Background Structural valve degeneration (SVD) remains a major complication of aortic bioprostheses. Purpose We aimed to assess the mode of SVD leading to bioprosthetic aortic valve failure (BVF) in a large series of patients. Methods Between 2010 and 2017, we prospectively enrolled 261 consecutive patients with BVF related to SVD. All patients underwent a clinical work-up. Explanted bioprostheses were analysed for assessing the mechanism of SVD. Results The delay from surgery to SVD diagnosis was 8.5±3.3 (1.7 to 21.4) years, 10 years after exclusion of a specific type of bioprosthesis. Of the 261 SVD patients, 150 (57%) had mainly a stenotic type, and 111 (43%) a regurgitant type. In regurgitant SVD bioprosthesis was more frequently porcine (19 vs 7%, P=0.002), prosthesis diameter was larger (23.2±2.5 vs 21.6±1.9 mm; P<0.0001), severe mismatch was less frequent (6 vs 17%, P=0.005), cardiovascular risk factors and especially diabetes, obesity and hypertension were less frequent, patients were more often in NYHA class 3–4 (64 vs 49%; p=0.015), Nt-pro BNP was significantly higher (P<0.0001), and diuretic treatment was more frequent (73 vs 61%, P=0.04). Bioprostheses were explanted during redo surgery in 112 (43%) patients. Of these 112 bioprostheses, moderate to severe calcifications were present in 94 (83.9%) and was the main cause of either stenotic (n=64, 57.1%) or regurgitant SVD. A cusp tear (n=46) accounted for 41.1% of the explanted SVD. A perforation, a recent thrombus or a delamination process were occasionally identified. Structural degeneration developed with minimal calcification in 18 (16.1%) bioprostheses. Conclusion Structural valve degeneration remains a matter of concern in current practice with a mean delay of 8 to 10 years after surgery. Beside classical SVD with extensive calcification process other types of SVD can be observed with minimal calcification.

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