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Updated: Apr 15, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
Published on: March 26, 2018
A fenestrated aortic valve contributing to iatrogenic aortic insufficiency post mitral valve replacement
A P Lee1, V M Walley1, K J Ascah2
1From Anatomical Pathology, Department of Laboratory Medicine, and the University of Ottawa Heart Institute at The Ottawa Civic Hospital Ottawa, Canada.
Abstract:
A case of an unusual local complication of cardiac valvular surgery is presented. Distortion of the geometry of the aortic valve base by a prosthetic mitral valve sewing ring allowed aortic insufficiency through the aortic valve's central orifice, as well as through an aortic valve cusp fenestration. During the 6 years after valve surgery, this patient developed chronic left heart failure contributed to by the aortic insufficiency and eventually, at age 65, required cardiac transplantation. Surgeons and pathologists should be aware of this unusual local complication of cardiac valve surgery, as it may have serious consequences.
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