ISSN: 2960-1959
Publisher
Case Reports

Aortic Root Enlargement During Redo Aortic Valve Replacement for Prosthetic Aortic Valve Dysfunction: A Case Report

Mosul Cardiac Center, Mousl, Iraq.
Mosul Cardiac Center, Mousl, Iraq.
Department of Cardiac Surgery, Ibn Albittar Cardiac Surgeon, Baghdad, Iraq.
College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
Smart Health Tower, François Mitterrand Street, Sulaimani, Kurdistan, Iraq
Kscien Organization for Scientific Research (Middle East office), Hamid Str, Azadi Mall, Sulaimani, Kurdstan, Iraq
Smart Health Tower, Madam Mitterrand Street, Sulaimani, Kurdistan, Iraq
Kscien Organization for Scientific Research (Middle East office), Hamid Str, Azadi Mall, Sulaimani, Kurdstan, Iraq

Abstract

Introduction

A variety of procedures for enlarging the aortic root have been described. The aim of the current study is to report a case of Redo aortic valve replacement that underwent Aortic root enlargement using a novel method.

Case presentation

A 32-year-old female with a history of severely stenotic aortic valve prothesis developed recurrent attacks of syncope and dyspnea on minimal effort. She had a past surgical history of AVR. Under general anesthesia in supine position re-sternotomy was done. The newly developed technique was done for the aortic root enlargement. There were no significant intra-operative complications. The patient remained two days in the Cardiac intensive care unit (ICU) and 15 days in the ward.

Conclusion

The technique previously described by Yang et al. can be used safely and efficiently to enlarge the aortic root in patients who have had redo aortic valve replacement.

References

  1. Chauvette V, Sénéchal M, Barrette V, Dagenais F, Mohammadi S, Kalavrouziotis D, et al. Annulus root enlargement during redo aortic valve replacement: Perioperative results and hemodynamic impact. Journal of Cardiac Surgery. 2020;35(9):2158-64. doi:10.1111/jocs.14726
  2. Doty JR, Raza S, Sabik III JF. Aortic Root Enlargement Techniques. InAtlas of Cardiac Surgical Techniques. Elsevier. 2019:(pp. 156-176). doi:10.1016/B978-0-323-46294-5.00011-X
  3. Mathers CD, Stevens GA, Boerma T, White RA, Tobias MI. Causes of international increases in older age life expectancy. The Lancet. 2015;385(9967):540-8. doi:10.1016/S0140-6736(14)60569-9
  4. Grubb KJ. Aortic root enlargement during aortic valve replacement: Nicks and Manouguian Techniques. Operative Techniques in Thoracic and Cardiovascular Surgery. 2015;20(3):206-18. doi:10.1053/j.optechstcvs.2016.02.004
  5. Haunschild J, Scharnowski S, Mende M, von Aspern K, Misfeld M, Mohr FW, et al. Aortic root enlargement to mitigate patient–prosthesis mismatch: do early adverse events justify reluctance?. European Journal of Cardio-Thoracic Surgery. 2019;56(2):335-42. doi:10.1093/ejcts/ezz016
  6. Massias SA, Pittams A, Mohamed M, Ahmed S, Younas H, Harky A. Aortic root enlargement: When and how. Journal of Cardiac Surgery. 2021;36(1):229-35. doi:10.1111/jocs.15175
  7. Yang B, Naeem A. AY incision and rectangular patch to enlarge the aortic annulus by three valve sizes. The Annals of Thoracic Surgery. 2021 Aug 1;112(2):139-41. doi:10.1016/j.athoracsur.2021.01.072
  8. Rahimtoola SH. The problem of valve prosthesis-patient mismatch. Circulation. 1978;58(1):20-4. doi:10.1161/01.CIR.58.1.20
  9. Correia PM, Coutinho GF, Branco C, Antunes MJ. Long-term follow-up of patients undergoing aortic root enlargement for insertion of a larger prosthesis. European Journal of Cardio-Thoracic Surgery. 2016;50(1):82-8. doi:10.1093/ejcts/ezv487
  10. Pibarot P, Dumesnil JG, Lemieux M, Cartier P, Metras J, Durand LG. Impact of prosthesis-patient mismatch on hemodynamic and clinical status in patients with an aortic valve bioprosthesis. Journal of the American College of Cardiology. 1998;31(2SA):399A. doi:N/A
  11. Antunes MJ. Commentary: aortic root enlargement, a useful and reproducible way to a larger prosthesis. The Journal of Thoracic and Cardiovascular Surgery. 2020;160(4):924-5. doi:10.1016/j.jtcvs.2019.09.049
  12. Nicks R, Cartmill T, Bernstein L. Hypoplasia of the aortic root: the problem of aortic valve replacement. Thorax. 1970;25(3):339-46. doi:10.1136%2Fthx.25.3.339
  13. Manouguian S, Seybold-Epting W. Patch enlargement of the aortic valve ring by extending the aortic incision into the anterior mitral leaflet: new operative technique. The Journal of thoracic and cardiovascular surgery. 1979;78(3):402-12. doi:10.1016/S0022-5223(19)38105-X
  14. Bonderman D, Graf A, Kammerlander AA, Kocher A, Laufer G, Lang IM, et al. Factors determining patient-prosthesis mismatch after aortic valve replacement–a prospective cohort study. PLoS One. 2013;8(12):e81940. doi:10.1371/journal.pone.0081940
  15. Kanter KR, Kirshbom PM, Kogon BE. Redo aortic valve replacement in children. The Annals of thoracic surgery. 2006;82(5):1594-7. doi:10.1016/j.athoracsur.2006.05.117

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