| A Case of Severe Aortic Stenosis
Accompanied by Porcelain Aorta Treated with an Apicoaortic Valved
Conduit |
(Department of Cardiovascular Surgery, Tachikawa
Medical Center, Nagaoka, Japan)
| Norihiko Saitoh |
Kazuo Yamamoto |
Satoshi Tanaka |
| Chizuo Kikuchi |
Tsutomu Sugimoto |
Shigetaka Kasuya |
|
The patient was a 70-year-old woman
with severe aortic stenosis and familial hyperlipidemia which
was diagnosed in 1994. The patient was admitted as an emergency
case due to syncope in 2002. According to ultrasound cardiography
(UCG), the pressure gradient of the aortic valve was 120.7mmHg,
and the diameter of the aortic valve annulus was 16.7mm. Computed
tomography showed porcelain aorta from the annulus of aortic
valve to the ascending aorta. On cardiac catheterization, the
pressure gradient was 96mmHg, AVA was 0.4cm2, and the ejection
fraction was 38.7%. Since these findings suggested that conventional
AVR was difficult, thoracotomy was performed at the left 5th
intercostal level, and apicoaortic valved conduit (valved graft:
SJM19HP, Intergard 22mm＋Medtronic apical LV connector) was implanted.
Postoperative cine MRI showed that most of the cardiac output
(87%, 3.29l/min) flowed
through the conduit, with the flow via the aortic valve accounting
for 13%, 0.51l/min. This surgical procedure can be an
effective alternative when conventional AVR is difficult.
Jpn. J. Cardiovasc. Surg. 33: 208-212 (2004) |
|
