Reoperation for Mid-term Failure of a Freestyle Bioprosthesis Using a Full Root Technique -A Surgical Case

The aortic root of a 30-year-old man was replaced with a Freestyle stentless aortic bioprosthesis for aortic regurgitation associated with annuloaortic ectasia. His clinical course was uneventful, and he was discharged without complications. Three years and six months after surgery, he presented wit...

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Bibliographic Details
Published in:Annals of Thoracic and Cardiovascular Surgery 2011/06/25, Vol.17(3), pp.287-289
Main Authors: Nakamura, Hiromasa, Yamaguchi, Hiroki, Nakao, Tatsuya, Oshima, Yu, Tokunaga, Noriyuki, Murakami, Mikiko, Mitsuyama, Shinichi
Format: Article
Language:English
Subjects:
Adult
Aortic Valve Insufficiency - diagnostic imaging
Aortic Valve Insufficiency - surgery
Bioprosthesis - adverse effects
Echocardiography, Transesophageal
Endocarditis - diagnostic imaging
Endocarditis - microbiology
Endocarditis - surgery
freestyle bioprosthesis
full root technique
Heart Valve Prosthesis - adverse effects
Heart Valve Prosthesis Implantation - adverse effects
Heart Valve Prosthesis Implantation - instrumentation
Humans
infective endocarditis
Male
Prosthesis Design
Prosthesis Failure
Prosthesis-Related Infections - diagnostic imaging
Prosthesis-Related Infections - microbiology
Prosthesis-Related Infections - surgery
Reoperation
Streptococcus - isolation & purification
Time Factors
Treatment Outcome
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Summary:The aortic root of a 30-year-old man was replaced with a Freestyle stentless aortic bioprosthesis for aortic regurgitation associated with annuloaortic ectasia. His clinical course was uneventful, and he was discharged without complications. Three years and six months after surgery, he presented with a high fever. Four years after surgery, transthoracic echocardiography revealed severe aortic regurgitation. We performed exploratory surgery and discovered a torn left coronary cusp of the Freestyle bioprosthesis. Organized vegetation was adherent to the left coronary cusp leaflet. The non-coronary cusp and the right coronary cusp were normal. The diagnosis was aortic regurgitation due to valve failure related to infective endocarditis. Consequently, we reconstructed the aortic root with a composite graft (26-mm Valsalva graft and a 21-mm ON-X mechanical valve).
ISSN:1341-1098
2186-1005
DOI:10.5761/atcs.cr.09.01532