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Single coronary artery with aortic valve replacement followed by aortic root replacement due to endocarditis: A case

Makoto Taoka1, Akira Sezai1, Masanao Ohba1

  • 1Department of Cardiovascular Surgery Nihon University School of Medicine Tokyo Japan.

Clinical Case Reports
|May 6, 2024
PubMed

Insights

Aortic valve replacement complicated by an aortic annular abscess required further surgery. Successful aortic root replacement and coronary artery bypass grafting resolved the infection and restored coronary artery flow.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Disease
  • Cardiac Surgery

Background:

  • Aortic stenosis necessitates aortic valve replacement.
  • Congenital single coronary artery presents unique surgical challenges.
  • Aortic annular abscess is a rare but serious complication post-valve surgery.

Observation:

  • A patient with a single coronary artery developed an aortic annular abscess two years after aortic valve replacement.
  • The abscess caused significant adhesions to the right coronary artery (RCA), complicating separation and risking future stenosis.
  • The patient presented with symptoms indicative of infection and potential coronary compromise.

Findings:

  • The patient underwent successful aortic root replacement and coronary artery bypass grafting (CABG) for the RCA.
  • A freestyle valve was used for aortic root reconstruction.
  • A saphenous vein graft was utilized for the RCA bypass, restoring adequate coronary perfusion.

Implications:

  • This case highlights the complex management of aortic annular abscesses in patients with coronary anomalies.
  • Successful surgical intervention can lead to long-term resolution of infection and symptom relief.
  • Adherence to sterile techniques and prompt management of post-operative infections are crucial in cardiac surgery.

Keywords:
freestyle valveprosthetic valve endocarditissingle coronary artery

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