Abstract
A 65-year-old man with aortic regurgitation underwent aortic valve replacement with a St. Jude Medical prosthetic valve about 6 years ago. At that time, the aortic root was slightly dilated at about 40 mm in diameter and the ascending aorta was within the normal range. This year, the man was diagnosed with an aortic root aneurysm in regular follow-up echocardiography. Chest-enhanced computed tomography and chest aortography at our hospital demonstrated a pear-like aortic root aneurysm about 60 mm in diameter. Elective operation for the aortic root aneurysm was conducted September 29, 1999, based on the Bentall procedure. Composite graft replacement with coronary reconstruction was conducted using a 28-mm Hemashield prosthetic graft and a 23-mm St. Jude Medical prosthetic valve under cardiopulmonary bypass. An 8-mm Hemashield graft was interposed on the left main coronary artery and the right coronary artery was directly anastomosed using a Carrel patch method. The postoperative course was uneventful and post-operative examination demonstrated good surgical results. Histological findings of the aortic aneurysm wall showed cystic medial necrosis. Surgical cases of aortic root aneurysm after aortic valve replacement are rare, but serious complications with the possibility of rupture or dissection warrant surgical intervention.
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Ergin MA, Spielvogel D, Apaydin A, Lansman SL, McCullough JN, Griepp RB. Surgical treatment of the dilated ascending aorta: When and how?. Ann Thorac Surg 1999; 67: 1834–9.
Prenger K, Pieters I, Cheriex E. Aortic dissection after aortic valve replacement: incidence and consequences for strategy. J Card Surg 1994; 9: 495–8.
Albat B, Thevenet A. Dissecting aneurysms of the ascending aorta occuring late after aortic valve replacement. J Cardiovasc Surg 1992; 33: 272–5.
Legget ME, Unger TA, O'Sullivan CK. Aortic root complications in Marfan's syndrome: identification of alower risk group. Heart 1996; 75: 389–95.
Natsuaki M, Itoh T, Rikitake K, Okazaki Y, Naitoh K Aortic complication after aortic valve replacement in patients with dilated ascending aorta and aortic regurgitation. J Heart Valve Dis 1998; 7: 504–9.
Suzuki H, Hirano R, Mizumoto T, Hiraiwa T, Yada I, Yuasa H. A case report of dissecting aneurysm (DeBakey type II) after aortic valve replacement. Jpn J Cardiovasc Surg 1994; 23: 445–7.
Uchita S, Watanabe S, Hayashi K, Yamanishi H. Late aortic dissection after aortic valve replacement for aortic regurgitation with slight aortic dilatation successfully repaired by the Bentall procedure. Jpn J Cardiovasc Srug 1994; 23: 355–9.
Sasaki A, Kazui T, Doi H, Sugiki K, Ohno T. Cabrol's operation for aortic root dilatation following AVR. Jpn J Cardiovasc Surg 1996; 25: 139–42.
Kim M, Roman MJ, Cavallini MC, Schwartz JE, Pichering TG, Devereux RB. Effect of hypertension on aortic root size and prevalence of aortic regurgitation. Hypertension 1996; 28: 47–52.
Seki K, Abe T, Kuribayashi R, Sekine S, Shibata Y, Yamagishi I. Aortic dissection with giant pseudoaneurysm as a rare late complication of aortic valve replacement. J Jpn Assn Thorac Surg 1994; 42: 1382–7.
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Furukawa, H., Niinami, H., Ichikawa, S. et al. Surgically treated aortic root aneurysm following aortic valve replacement. Jpn J Thorac Cardiovasc Surg 49, 85–88 (2001). https://doi.org/10.1007/BF02913130
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DOI: https://doi.org/10.1007/BF02913130