[Transseptal suture fixation in the management of prosthetic valve dehiscence]

Valve dehiscence resulted from prosthetic valve endocarditis and aortitis is the most common cause of the reoperation after prosthetic valve replacement. In our experience, the results of reoperation has been far from satisfactory. For the successful management of prosthetic dehiscence, we have adopted the transseptal suture technique of accurately securing the prosthetic valve. Five patients with prosthetic valve dehiscence and one patient with native valve endocarditis were operated upon using the transseptal techniques. Left ventricular-aortic discontinuity was repaired using composite valve-tube graft together with this technique in two patients. All but one patient who succumbed to multiple organ failure induced by preoperative hemodynamic deterioration have survived the operation without recurrent infective endocarditis or valve dehiscence.