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Aortic root pseudoaneurysm following surgery for aortic valve endocarditis.
Kuei-Ton Tsai1, Nye-Jen Cheng, Jaw-Ji Chu
1Department of Surgery, Chang Gung Memorial Hospital, Niaosung, Kaohsiung, Taiwan, ROC. kttsai@adm.cgmh.org.tw
Chang Gung Medical Journal
|April 16, 2002
Summary
Prosthetic aortic valve replacement for endocarditis can lead to rare pseudoaneurysms. Aortic root homograft replacement successfully treated this complication, restoring cardiac function.
Area of Science:
- Cardiovascular Surgery
- Infective Endocarditis
- Aortic Valve Disease
Background:
- Prosthetic aortic valve replacement is standard for aortic valve endocarditis.
- Complex cases with annular destruction pose reoperation challenges.
- Complications like pseudoaneurysms can arise post-prosthetic valve replacement.
Observation:
- A patient developed congestive heart failure 3 months after prosthetic aortic valve replacement for endocarditis.
- A giant pseudoaneurysm around the aortic root was diagnosed without recurrent infection.
- The pseudoaneurysm caused rapid hemodynamic deterioration, necessitating reoperation.
Findings:
- Reoperation involved a cryopreserved aortic homograft for aortic root replacement.
- Bilateral coronary artery buttons were reimplanted.
- The pseudoaneurysm was exteriorized, and the left ventricular outflow tract reconstructed.
Implications:
- Aortic root pseudoaneurysm is a rare but serious complication of prosthetic aortic valve replacement for endocarditis.
- Homograft aortic root replacement is an effective treatment for this complex condition.
- This approach offers a versatile solution for patients with hemodynamic compromise and complex aortic root pathology.
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