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Redo aortic root replacement (Cabrol procedure) and Commando operation for extensive prosthetic valve endocarditis

Joon Young Kim1, Jae Suk Yoo1

  • 1Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|July 30, 2025
PubMed

Insights

This case report details a complex surgical repair of a ruptured mitral-aortic intervalvular fibrosa pseudoaneurysm and aortic root abscess. The integrated approach successfully treated a high-risk patient with prior cardiac operations.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Thoracic Surgery

Background:

  • Mitral-aortic intervalvular fibrosa pseudoaneurysm is a rare, life-threatening complication.
  • Rupture presents a surgical emergency with high mortality (20-30%).
  • Often associated with infective endocarditis or previous cardiac surgery.

Purpose of the Study:

  • To report a successful surgical management of a contained rupture of a mitral-aortic intervalvular fibrosa pseudoaneurysm.
  • To highlight the effectiveness of combined complex surgical techniques in high-risk reoperative cases.

Main Methods:

  • Surgical repair of a contained mitral-aortic intervalvular fibrosa pseudoaneurysm rupture and aortic root abscess.
  • Utilized a Commando operation with a modified bio-Bentall procedure.
  • Employed mitral-aortic intervalvular fibrosa reconstruction with a bovine pericardial patch and Cabrol procedure for coronary artery reimplantation.

Main Results:

  • Successful debridement of infected aortic root tissue.
  • Complete repair of the mitral-aortic intervalvular fibrosa defect.
  • Favorable outcome in a high-risk, reoperative patient.

Conclusions:

  • Combined complex surgical techniques can effectively manage mitral-aortic intervalvular fibrosa pseudoaneurysm rupture and aortic root abscess.
  • This integrated approach is valuable in select high-risk reoperative settings.
  • Successful management of this rare complication is achievable.
Keywords:
Adult patientAortic valve replacementPseudoaneurysmRedo cardiac surgery

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