New technique of concomitant replacement of the aortic valve and the ascending aorta with enlargement of the aortic annulus for congenital bicuspid aortic valve

Congenital bicuspid aortic valve (BAV) is one of the most common congenital heart diseases, with a high incidence of associated valvular lesions and aortic abnormalities including aortic stenosis( AS), aortic regurgitation, aortic dilatation, and aortic dissection. Patients with BAV and AS often hav...

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Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 65; no. 13; p. 1135
Main Authors Takahara, Shingo, Fukasawa, Manabu, Kawahara, Yu, Suzuki, Kotaro, Kobayashi, Yuriko
Format Journal Article
LanguageJapanese
Published Japan 01.12.2012
Subjects
Aorta - surgery
Aortic Valve - abnormalities
Aortic Valve - surgery
Aortic Valve Stenosis - surgery
Bicuspid Aortic Valve Disease
Cardiovascular Surgical Procedures - methods
Female
Heart Valve Diseases - surgery
Heart Valve Prosthesis
Humans
Middle Aged
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Summary:Congenital bicuspid aortic valve (BAV) is one of the most common congenital heart diseases, with a high incidence of associated valvular lesions and aortic abnormalities including aortic stenosis( AS), aortic regurgitation, aortic dilatation, and aortic dissection. Patients with BAV and AS often have a small aortic annulus. We encountered a case of BAV in which a 51-year-old woman with severe AS having a small aortic annulus and a dilated ascending aorta required surgical intervention. We performed the surgery using new technique that involved concomitant replacement of the aortic valve and the ascending aorta with enlargement of the aortic annulus using a single uniquely-shaped graft to avoid prosthesis patient mismatch. We trimmed the proximal end of the straight graft in shape of 2 teardrops hanging on it to fit the cut annulus. It requires only a single suture line to replace the ascending aorta and enlarge the aortic annulus, which entails a decreased risk of bleeding during surgery. We believe that it could be applicable to many cases requiring concomitant surgery.
ISSN:0021-5252