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Updated: Jun 11, 2026
14:14
Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Aortoventricular disruption after aortic valve replacement: a rare complication.
Teruya Nakamura1, Hironori Izutani, Takanori Shibukawa
1Division of Cardiovascular Surgery, National Hospital Organization Kure Medical Center/Chugoku Cancer Center, 3-1 Aoyama-Cho, Kure 737-0023, Japan. teruyan@kure-nh.go.jp
Interactive Cardiovascular and Thoracic Surgery
|July 3, 2010
Summary
Aortoventricular disruption is a rare complication following aortic valve replacement. Surgeons must be cautious with deep sutures near the left coronary annulus to prevent this serious cardiac injury.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
Background:
- Aortic valve replacement (AVR) is a common procedure.
- Aortoventricular disruption is an exceedingly rare but severe complication post-AVR.
Observation:
- A case report details a 76-year-old male experiencing aortoventricular disruption after AVR with a tissue valve and ascending aortic aneurysm repair.
- Pulsatile bleeding from the aortic root necessitated re-initiation of cardiopulmonary bypass.
Findings:
- The ventricular rupture occurred below the left coronary annulus, attributed to valve sutures tearing the ventricular myocardium.
- Sutures with pledgets and Dacron patch reinforcement were used for internal repair.
- The patient recovered and was discharged without major complications.
Implications:
- Deep everting mattress sutures placed on the left coronary annulus during AVR pose a risk for aortoventricular disruption.
- Surgical awareness and careful technique, avoiding overstretching the posterior aortoventricular junction, are crucial to prevent this complication.
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