Aortic Valve Re-Replacement with Aortic Root Enlargement for Aortic Valvular Stenosis after Aortic Valve Implantation with a Freestyle Stentless Porcine Valve

(Division of Cardiovascular Surgery, Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki, Japan and Department of Pathology, Nagasaki University Hospital of Medicine and Dentistry*, Nagasaki, Japan)

Ichiro Matsumaru Kiyoyuki Eishi Shiro Yamachika
Shiro Hazama Tsuneo Ariyoshi Hideaki Takai
Shun Nakaji Kuniko Abe* Tomayoshi Hayashi*
We present a successfully treated case of re-operation for aortic valvular stenosis caused by implantation of a stentless prosthesis using oversizing sub-coronary insertion in a young woman. The 17-year-old Japanese woman received aortic valve replacement (AVR) with a 21mm Freestyle stentless porcine valve (Medtronic Inc.), using the oversizing modified sub-coronary insertion because of infectious endocarditis 12 years previously at another hospital. Just after the operation, she suffered severe heart failure. At 16 years old, since a cardiac murmur and dyspnea on effort appeared, and she presented severe heart failure due to significant aortic valvular stenosis with a mean aortic valve gradient 115mmHg, we performed aortic valve re-replacement (ATS AP 18mm) with an aortic root enlargement procedure. Intraoperative findings suggested that the oversizing technique was related to aortic valvular stenosis. The postoperative course has been uneventful.
@Jpn.J. Cardiovasc. Surg. 33: 425-428 (2004)