Late Aortic Dissection after Aortic Valve Replacement for Aortic Regurgitation with Slight Aortic Dilatation Successfully Repaired by the Bentall Procedure
We report a 57-year-old male who suffered from ascending aortic aneurysmal dilatation complicated with acute localized dissection. He had received aortic valve replacement with a prosthesis for severe aortic regurgitation resulting from valve degeneration and annular dilatation 4 years previously at...
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| Published in | Japanese Journal of Cardiovascular Surgery Vol. 23; no. 5; pp. 355 - 359 |
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| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
The Japanese Society for Cardiovascular Surgery
15.09.1994
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| Online Access | Get full text |
| ISSN | 0285-1474 1883-4108 |
| DOI | 10.4326/jjcvs.23.355 |
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| Abstract | We report a 57-year-old male who suffered from ascending aortic aneurysmal dilatation complicated with acute localized dissection. He had received aortic valve replacement with a prosthesis for severe aortic regurgitation resulting from valve degeneration and annular dilatation 4 years previously at which time the maximal ascending aortic diameter had been 45mm so that a procedure for the aorta itself was not done. On the present occasion an aortogram showed a maximal aortic diameter of 90mm and localized dissection from above the right coronary ostium to near the connection to the brachiocephalic artery. A successful composite valve-graft replacement of the ascending aorta (Bentall procedure with Piehler's modification) was carried out on a semi-emergency basis. This experience with this case implies that certain intervention for associated moderate aortic dilatation should be considered when an aortic valve replacement is performed. |
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| AbstractList | We report a 57-year-old male who suffered from ascending aortic aneurysmal dilatation complicated with acute localized dissection. He had received aortic valve replacement with a prosthesis for severe aortic regurgitation resulting from valve degeneration and annular dilatation 4 years previously at which time the maximal ascending aortic diameter had been 45mm so that a procedure for the aorta itself was not done. On the present occasion an aortogram showed a maximal aortic diameter of 90mm and localized dissection from above the right coronary ostium to near the connection to the brachiocephalic artery. A successful composite valve-graft replacement of the ascending aorta (Bentall procedure with Piehler's modification) was carried out on a semi-emergency basis. This experience with this case implies that certain intervention for associated moderate aortic dilatation should be considered when an aortic valve replacement is performed. |
| Author | Watanabe, Sunao Hayashi, Kazuhide Yamanishi, Hideki Uchita, Shunji |
| Author_xml | – sequence: 1 fullname: Uchita, Shunji organization: Department of Cardiovascular Surgery, Hokko Cardiovascular Hospital – sequence: 1 fullname: Hayashi, Kazuhide organization: Department of Cardiovascular Surgery, Hokko Cardiovascular Hospital – sequence: 1 fullname: Watanabe, Sunao organization: Department of Cardiovascular Surgery, Hokko Cardiovascular Hospital – sequence: 1 fullname: Yamanishi, Hideki organization: Department of Cardiovascular Surgery, Hokko Cardiovascular Hospital |
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| References | 7) Robicsek, F.: A new method to treat fusiform aneurysms of the ascending aorta associated with aortic valve disease: An alternative to radical resection. Ann. Thorac. Surg. 34: 92-94, 1982. 9) Milgalter, E. and Laks, H.: Dacron mesh wrapping to support the aneurysmally dilated or friable ascending aorta. Ann. Thorac. Surg. 52: 874-876, 1991. 2) Björk, V. O., Henze, A. and Jereb, M.: Aorto-graphic follow up in patients with the Björk-Shiley aortic disc valve prosthesis. Scand. J. Thorac. Cardiovasc. Surg. 7: 1-6, 1973. 1) 迫秀則, 葉玉哲生, 高橋英巳ほか: 大動脈弁置換術後遠隔期に DeBakey I型急性大動脈解離を発症した1症例. 胸部外科46: 332-335, 1993. 8) Olinger, G. N., Schweiger, J. A. and Galbraith, J. A.: Primary repair of acute ascending aortic dissection. Ann. Thorac. Surg. 44: 389-393, 1987. 5) Robicsek, F., Daugherty, H. K., Mullen, D. C. et al.: Long-range observations with external aortic grafts. J. Cardiovasc. Surg. 17: 195-201, 1976. 4) Robicsek, F., Perkins, R. S., Colonel, L. et al.: Fusiform aneurysm of the entire aortic arch. J. Thorac. Cardiovasc. Surg. 63: 756-759, 1972. 10) Dhillon, J. S., Randhawa, G. K., Straehley, C. J. et al.: Late rupture after Dacron wrapping of aortic aneurysms. Circulation 74 (Suppl. I) 11-14, 1986. 3) Robicsek, F., Daugherty, H. K. and Mullen, D. C.: External grafting of aortic aneurysms. J. Thorac. Cardiovasc. Surg. 61: 131-134, 1971. 6) Tanabe, T., Kubo, Y., Hashimoto, M. et al.: Wall reinforcement with high porous Dacron mesh in aortic surgery. Ann. Surg. 191: 452-455, 1980. |
| References_xml | – reference: 3) Robicsek, F., Daugherty, H. K. and Mullen, D. C.: External grafting of aortic aneurysms. J. Thorac. Cardiovasc. Surg. 61: 131-134, 1971. – reference: 5) Robicsek, F., Daugherty, H. K., Mullen, D. C. et al.: Long-range observations with external aortic grafts. J. Cardiovasc. Surg. 17: 195-201, 1976. – reference: 7) Robicsek, F.: A new method to treat fusiform aneurysms of the ascending aorta associated with aortic valve disease: An alternative to radical resection. Ann. Thorac. Surg. 34: 92-94, 1982. – reference: 6) Tanabe, T., Kubo, Y., Hashimoto, M. et al.: Wall reinforcement with high porous Dacron mesh in aortic surgery. Ann. Surg. 191: 452-455, 1980. – reference: 8) Olinger, G. N., Schweiger, J. A. and Galbraith, J. A.: Primary repair of acute ascending aortic dissection. Ann. Thorac. Surg. 44: 389-393, 1987. – reference: 2) Björk, V. O., Henze, A. and Jereb, M.: Aorto-graphic follow up in patients with the Björk-Shiley aortic disc valve prosthesis. Scand. J. Thorac. Cardiovasc. Surg. 7: 1-6, 1973. – reference: 10) Dhillon, J. S., Randhawa, G. K., Straehley, C. J. et al.: Late rupture after Dacron wrapping of aortic aneurysms. Circulation 74 (Suppl. I) 11-14, 1986. – reference: 1) 迫秀則, 葉玉哲生, 高橋英巳ほか: 大動脈弁置換術後遠隔期に DeBakey I型急性大動脈解離を発症した1症例. 胸部外科46: 332-335, 1993. – reference: 4) Robicsek, F., Perkins, R. S., Colonel, L. et al.: Fusiform aneurysm of the entire aortic arch. J. Thorac. Cardiovasc. Surg. 63: 756-759, 1972. – reference: 9) Milgalter, E. and Laks, H.: Dacron mesh wrapping to support the aneurysmally dilated or friable ascending aorta. Ann. Thorac. Surg. 52: 874-876, 1991. |
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| Snippet | We report a 57-year-old male who suffered from ascending aortic aneurysmal dilatation complicated with acute localized dissection. He had received aortic valve... |
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| Title | Late Aortic Dissection after Aortic Valve Replacement for Aortic Regurgitation with Slight Aortic Dilatation Successfully Repaired by the Bentall Procedure |
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