The Ascending Aorta Pseudoaneurysm with Myocardium Rupture Complicated with Prosthetic Valve Infective Endocarditis after Aortic Valve Replacement

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.

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

10.37191/mapsci-jccr-2(2)-026 ◽

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.

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A case of aggressive aortic prosthetic valve endocarditis aggressive caused by Staphylococcus lugdunensis

Surgical Case Reports ◽

10.1186/s40792-020-01062-x ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Kazuhiro Yamazaki ◽

Kenji Minakata ◽

Kazuhisa Sakamoto ◽

Jiro Sakai ◽

Yujiro Ide ◽

...

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Valve Replacement ◽

Prosthetic Valve ◽

Pathogenic Bacteria ◽

Prosthetic Valve Endocarditis ◽

Drug Susceptibility ◽

Coagulase Negative Staphylococcus ◽

Staphylococcus Lugdunensis

Abstract Background Staphylococcus lugdunensis is a coagulase-negative Staphylococcus species, which are weak pathogenic bacteria generally. However, the acute and severe pathogenicity of Staphylococcus lugdunensis infective endocarditis may be due to the rapid growth of large vegetation and consequent valve destruction. Case presentation The patient was an 81-year-old male who visited our hospital with chief complaints of low back pain and high fever. Four years before this visit, he had undergone aortic valve replacement for aortic regurgitation. He was found to be hypotensive. Although there is no heart murmur on auscultation and echocardiography revealed negative findings with aortic valve, a blood test showed increases in the white blood cell count and C-reactive protein concentration. On the next day, Gram-positive cocci were detected in a blood culture and echocardiography detected a large vegetation on the prosthetic valve with increased flow velocity. Therefore, he underwent redo aortic valve replacement emergently. Staphylococcus lugdunensis was identified in blood samples and vegetation culture. Consequently, the patient was treated with antibiotics for 5 weeks after the operation and discharged home. Conclusions We experienced rapidly progressive prosthetic valve endocarditis caused by Staphylococcus lugdunensis. Hence, Staphylococcus lugdunensis infective endocarditis requires aggressive treatment, and the pathogenicity of this coagulase-negative Staphylococcus with high drug susceptibility should not be underestimated.

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Cardiac Rehabilitation for a Skydiver After Aortic Valve Replacement for Pure Aortic Regurgitation and Resection of the Ascending Aorta Complicated by Active Infective Endocarditis and Heart Block Requiring a Pacemaker

Baylor University Medical Center Proceedings ◽

10.1080/08998280.2017.11929601 ◽

2017 ◽

Vol 30 (2) ◽

pp. 234-236

Author(s):

Tonja R. Solomon ◽

Sandra Dejong ◽

Tim Bilbrey ◽

Pasquale Carbone ◽

Mark Campbell ◽

...

Keyword(s):

Infective Endocarditis ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Cardiac Rehabilitation ◽

Aortic Regurgitation ◽

Valve Replacement ◽

Heart Block ◽

Ascending Aorta ◽

Active Infective Endocarditis

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

10.22541/au.161950483.31367417/v1 ◽

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.

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