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Aortic root destruction after aortic valvuloplasty for bicuspid aortic valve
Mitsutaka Nakao1, Michio Yoshitake2, Yoko Matsumura2
1Department of Cardiac Surgery, The Jikei University School of Medicine, 3-9-18, Nishi-shinbashi, Minato-ku, Tokyo, 105-8571, Japan. mit.nakao@jikei.ac.jp.
General Thoracic and Cardiovascular Surgery
|July 27, 2020
Summary
A rare case of aortic root destruction occurred after external suture annuloplasty in a young man with bicuspid aortic valve and severe aortic regurgitation. Redo surgery revealed ePTFE suture within the aorta, necessitating aortic root replacement.
Area of Science:
- Cardiovascular Surgery
- Cardiac Surgery
- Aortic Valve Disease
Background:
- Bicuspid aortic valve is a common congenital heart defect.
- Severe aortic regurgitation can lead to aortic root dilatation.
- External suture annuloplasty is a surgical technique to repair aortic valve annulus.
Observation:
- A 27-year-old man with bicuspid aortic valve and severe aortic regurgitation underwent aortic valvuloplasty with external suture annuloplasty.
- Recurrent aortic regurgitation developed 7 months post-surgery.
- Intraoperative findings during redo surgery revealed an ePTFE suture within the aorta and significant aortic root damage.
Findings:
- External suture annuloplasty using ePTFE led to aortic root destruction.
- The aortic annulus was damaged with multiple holes on all aortic valve cusps.
- Aortic root replacement with a mechanical composite graft was required due to extensive damage.
Implications:
- This case highlights a rare complication of external suture annuloplasty.
- Careful patient selection and surgical technique are crucial in aortic valve repair.
- Further research may be needed to understand the long-term outcomes of external suture annuloplasty in complex aortic valve disease.
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