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Related Experiment Videos

Left ventricular outflow tract pseudoaneurysm after aortic valve replacement: case report.

Shigeaki Aoyagi1, Shuji Fukunaga, Hiroyuki Otsuka

  • 1Department of Surgery, Kurume University School of Medicine, Kurume, Japan. aoyagi@med.kurume-u.ac.jp

The Journal of Heart Valve Disease
|February 10, 2004
PubMed
Summary

A rare pseudoaneurysm formed in the mitral-aortic intervalvular fibrosa after aortic valve re-replacement. Surgical trauma during valve removal is the suspected cause of this serious cardiac complication.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Imaging
  • Aortic Valve Disease

Background:

  • A 68-year-old woman presented with angina and fatigue three months post aortic valve re-replacement.
  • She had no signs of infective endocarditis, a common complication after valve surgery.

Observation:

  • Transesophageal echocardiography identified an echo-free cavity in the mitral-aortic intervalvular fibrosa, communicating with the left ventricular outflow tract.
  • Left ventriculography confirmed a pulsatile cavity below the aortic prosthetic valve.
  • Coronary angiography revealed significant proximal right coronary artery stenosis.

Findings:

  • The study identified a pseudoaneurysm in the mitral-aortic intervalvular fibrosa region.
  • This was successfully treated with pseudoaneurysm closure, aortic root replacement, and coronary artery reconstruction.

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Implications:

  • Surgical trauma during prosthetic valve removal may lead to pseudoaneurysm formation.
  • Prompt diagnosis and surgical intervention are crucial for managing this rare complication.
  • This case highlights the importance of meticulous surgical technique in valve replacement procedures.