scholarly journals A 12.8 cm Diameter: Giant Aortic Aneurysm (GAA) Successfully Treated by Bentall’s Procedure- Case Report

2021 ◽  
Author(s):  
Anirudh Mathur
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Rare Complication ◽  
Stable Condition ◽  
Ascending Aorta ◽  
Ascending Aortic Aneurysm ◽  
Severe Aortic Regurgitation

Background: Aortic root aneurysm involves dilatation of sinuses of Valsalva, sinotubular junction, and proximal ascending aorta. It is a rare complication after aortic valve replacement surgery. A giant aneurysm is defined as an aneurysm of size> 10 cm. Surgical treatment involves Bentall’s procedure. Case Detail: A 40-year-old gentleman with severe aortic regurgitation and moderate aortic stenosis underwent aortic valve replacement with a mechanical prosthetic valve of size 25 mm, 13 years ago. At the time of previous surgery, the ascending aorta was mildly dilated, measured 3.5 cm in size. The patient came with complaints of breathlessness on exertion from the past two months, NYHA class III. Echocardiography and CECT revealed a giant ascending aortic aneurysm about 12.8 cm in diameter with intimal flap suggestive of dissection. Prosthetic valve function and other cardiac structures were assessed as normal. Elective surgery was planned. CPB was established. Ascending aortic aneurysm was excised along with a prosthetic mechanical valve. Bentall’s procedure was done using a 27 mm Dacron composite graft. The patient required a permanent pacemaker for a complete heart block in the postoperative period. Thereafter patient was discharged in stable condition. Conclusion: Aortic aneurysm should be tackled surgically in order to decrease morbidity and mortality. Regular follow-up of such patients should be done.

scholarly journals A 12.8 CM DIAMETER: GIANT AORTIC ANEURYSM (GAA) SUCCESSFULLY TREATED BY BENTALL’S PROCEDURE- Case Report

2021 ◽  
Author(s):  
ANIRUDH MATHUR ◽  
Om Yadava ◽  
Vikas Ahlawat ◽  
Amita Yadav ◽  
Anirban Kundu
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Axillary Artery ◽  
Stable Condition ◽  
Ascending Aorta ◽  
Ascending Aortic Aneurysm ◽  
Severe Aortic Regurgitation

Background: Aortic root aneurysm involves dilatation of sinuses of Valsalva, sinotubular junction and proximal ascending aorta. It is a rare complication after aortic valve replacement surgery. Giant aneurysm is defined as aneurysm of size> 10 cm. Surgical treatment involves Bentall’s procedure. Case Detail: A 40 year old gentleman with severe aortic regurgitation and moderate aortic stenosis underwent aortic valve replacement with a mechanical prosthetic valve of size 25 mm, 13 years ago. At the time of this surgery the ascending aorta was mildly dilated, measured 3.5 cm in size. Patient came with complaints of breathlessness on exertion from past two months, NYHA class III. Echocardiography and CECT revealed giant ascending aortic aneurysm about 12.8 cm in diameter with intimal flap suggestive of dissection. Prosthetic valve function and other cardiac structures were assessed as normal. Elective surgery was planned. CPB established via right axillary artery and right femoral vein. Ascending aortic aneurysm was excised along with prosthetic mechanical valve. Bentall’s procedure was done using 27 mm Dacron composite graft. Patient required permanent pacemaker for complete heart block in post operative period. Thereafter patient was discharged in stable condition. Conclusion: Aortic aneurysm should be tackled surgically in order to decrease the morbidity and mortality. Regular follow up of such patients should be done.

Giant ascending aortic aneurysm after aortic valve replacement

2020 ◽  
Vol 35 (8) ◽  
pp. 2033-2034
Author(s):  
Mihaela I. Dregoesc ◽  
Cătălin A. Trifan ◽  
Svetlana Encica ◽  
Wael Halloumi ◽  
Adrian C. Iancu
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Ascending Aortic Aneurysm

Ross Procedure: How to Do It and How to Teach It

2019 ◽  
Vol 10 (5) ◽  
pp. 624-627
Author(s):  
Jeremy L. Herrmann ◽  
Amanda R. Stram ◽  
John W. Brown
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Pulmonary Valve ◽  
Prosthetic Graft ◽  
Ascending Aorta ◽  
Ross Procedure

Prosthesis choice for aortic valve replacement (AVR) in children is frequently compromised by unavailability of prostheses in very small sizes, the lack of prosthetic valve growth, and risks associated with long-term anticoagulation. The Ross procedure with pulmonary valve autograft offers several advantages for pediatric and adult patients. We describe our current Ross AVR technique including replacement of the ascending aorta with a prosthetic graft. The procedure shown in the video involves an adult-sized male with a bicuspid aortic valve, mixed aortic stenosis and insufficiency, and a dilated ascending aorta.

scholarly journals Cutaneous-Pericardial Fistula: Rare Complication of Transapical Aortic Valve Replacement—Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Andrei Tarus ◽  
Mihail Enache ◽  
Igor Nedelciuc ◽  
Iulian Rotaru ◽  
Alberto Emanuel Bacusca ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Rare Complication ◽  
Site Infection ◽  
Operative Trauma ◽  
Adjacent Structures ◽  
Wide Range ◽  
Life Threatening

Cutaneous-pericardial fistula is a rare complication of transapical aortic valve replacement; only a few cases are reported in the literature. It is part of a wide range of surgical site infection manifestations that could emerge after surgery. Due to its proximity to the heart, the risk of infectious lesions of adjacent structures and inoculation of pathogens on the prosthetic valve can lead to life-threatening complications. We report here a case of successful surgical treatment through reduced ribs and soft tissue operative trauma.

scholarly journals Ascending aortic aneurysm repair 44 years after Starr–Edwards caged-ball aortic valve replacement

2018 ◽  
Vol 54 (5) ◽  
pp. 962-963
Author(s):  
Gabrielle E Hatton ◽  
Akiko Tanaka ◽  
Anthony L Estrera
Keyword(s):  
Aortic Valve ◽  
Aortic Aneurysm ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Anticoagulation Therapy ◽  
Ball Valve ◽  
Ascending Aortic Aneurysm ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

Abstract We report a case of ascending aortic aneurysm repair and redo aortic valve replacement with a bioprosthesis 44 years after aortic valve replacement with a Starr–Edwards metal caged-ball prosthesis. The patient presented with a moderately stenotic caged-ball valve and a 50-mm ascending aortic aneurysm on a routine follow-up transthoracic echocardiography. We replaced the valve with a bioprosthesis at the time of aortic repair as the patient wished to stop anticoagulation therapy. Intraoperatively, we found that the cloth covering of the cage was nearly completely destroyed.

scholarly journals Corynebacterium striatum prosthetic valve endocarditis with severe aortic regurgitation successfully treated with transcatheter aortic valve replacement

2018 ◽  
Vol 11 (1) ◽  
pp. e226881 ◽  
Author(s):  
Syed Yaseen Naqvi ◽  
Ibrahim G Salama ◽  
Craig Narins ◽  
Thomas Stuver
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Prosthetic Valve ◽  
Recurrent Infection ◽  
Prosthetic Valve Endocarditis ◽  
Severe Aortic Regurgitation ◽  
Transcatheter Aortic Valve ◽  
Corynebacterium Striatum

We describe the case of a 69-year-old man with a history of bioprosthetic aortic valve replacement who presented with Corynebacterium striatum prosthetic valve endocarditis (PVE) complicated by severe aortic insufficiency with refractory cardiogenic shock despite antibiotic therapy. He was considered a prohibitive-risk surgical candidate due to co-morbid conditions and off-label valve-in-valve transcatheter aortic valve replacement (TAVR) was performed after detailed multidisciplinary evaluation. He recovered well without recurrent infection following completion of antibiotics and transthoracic echocardiogram at 12 months showed a normal functioning prosthetic valve. To our knowledge, this is the first reported case of native or PVE treated with TAVR.

scholarly journals P709 Rare complication of delayed iatrogenic critical left main coronary (LMC) occlusion after a re-do aortic valve replacement (AVR) post an acute prosthetic valve intrinsic dysfunction in a young patient

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Fady ◽  
A M Komaranchath ◽  
F B Al Bakshy ◽  
M K Kakani
Keyword(s):  
Aortic Valve ◽  
Young Patient ◽  
Valve Replacement ◽  
Prosthetic Valve ◽  
Rare Complication ◽  
Nyha Class ◽  
Coronary Intervention ◽  
Intrinsic Defect ◽  
Class Iii ◽  
Severe Aortic Regurgitation

Abstract Funding Acknowledgements Nil Introduction Delayed LMC obstruction is quite a rare but fatal complication of surgical AVR. It is iatrogenic however can be induced by embolization of aortic calcium plaque or surgical over-tightening of the new aortic valve suture ring over the LMC ostium during surgery Case report Herein, we report a case of LMC severe ostial obstruction that occurred 30 days post a re-do surgical AVR for a young 38-year-old male young patient. The patient presented with palpitations, dyspnea NYHA class III and general fatigue started 4 weeks earlier. Diagnosed by 2D transthoracic echo (TTE) as bicuspid aortic valve (BAV) with severe aortic regurgitation (AR), grade II-III mitral regurgitation (MR) and severe pulmonary hypertension with estimated LV ejection fraction (LVEF) of 40%. Transesophageal echo (TEE) confirmed the same however demonstrated the MR grade as severe. Hence posted for a double valve replacement (DVR) surgery. Preoperative coronary angiography (CAG) revealed normal coronaries. Intraoperative TEE showed well-functioning both prostheses. On day 5 postoperatively patient developed dyspnea, orthopnea and was restless. Bed side 2D echo both revealed severe eccentric AR with query one stuck disc of the AV prosthesis in the setting of acute severe LV dysfunction with LVEF of 20%. Cinefluoroscopy confirmed our diagnosis of one stuck disc in an opened position. We attempted to mobilize the disc using a 0.035 wire through the aorta, however, this proved unsuccessful. So, we scheduled the patient for an urgent redo AVR. Intraoperative inspection of the resected prosthesis ruled out thrombosis and revealed that the disc was immobile secondary to a manufacturing intrinsic defect. Intraoperative TEE confirmed a successful redo AVR with normal new prosthesis function. Patient made a steady recovery and was discharged 7 days later. Screening TTE before discharge showed improved LVEF from 20% to 35%. Patient presented 30 days later with new onset classic angina on effort. Our greatest fear of a complicated delayed iatrogenic critical LMC occlusion was proven on CAG that showed a discrete 90% stenosis of ostial LMC artery. we underwent an intravascular ultrasound (IVUS)- guided successful percutaneous coronary intervention to ostial LMC artery after which patient recovered very well. TTE before discharge showed further improvement of LVEF to 50%. He was followed up for two years later with no complications neither any symptoms. Conclusions Although a very rare complication, however endogenous intrinsic defect of the prosthetic valve might be fatal with acute decompensation and complications that merit immediate action. With the help of multimodal imaging we were able to timely diagnosis and illustrate the cause and extent of acute prosthesis dysfunction. It is very important to have a high diagnostic suspicion if signs of myocardial ischemia occur after surgical AVR even if delayed as occurred in our patient. Abstract P709 Figure. Severe AR-Prosthesis dysfunction-LM obst

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