Treatment of Isolated Type Ic Lesion-Induced Aortic Regurgitation by External Suture Annuloplasty Alone

Minoru Matsuhama＊	Satoshi Arimura＊	Kenichi Sasaki＊＊
Takashi Kunihara＊＊＊

（Department of Cardiovascular Surgery, The Cardiovascular Institute＊, Tokyo, Japan, Department of Cardiovascular Surgery, Saitama Sekishinkai Hospital＊＊, Saitama, Japan, and Department of Cardiac Surgery, The Jikei University School of Medicine＊＊＊, Tokyo, Japan）

A diagnosis of active aortic valve endocarditis was made in a 52-year-old man who presented with fever and edema. Blood cultures were positive for Streptococcus gallolyticus subsp. pasteurianus. The infection was treated successfully using antibiotics and dental care, but a mobile vegetation-like structure on the aortic valve and severe aortic regurgitation, mainly due to aortic annulus dilatation, remained and required surgery. During the surgical procedure, the aortic valve leaflets were seen to be almost normal, and the regurgitation was found to be mainly due to aortic annulus dilation. Regurgitation could be managed with external suture annuloplasty alone, although a second session was necessary to reduce the annular size by one size. The annular size has been stable for over 1 year after surgery without re-operation of the aortic valve. This procedure not only reduces the operation time but also decreases the surgical stress and avoids the need for prosthetic valve replacement.
　　

Jpn. J. Cardiovasc. Surg. 48:239-244（2019）

Keywords：aortic regurgitation;aortic annulus dilatation;aortic valvuloplasty;external suture annuloplasty;infective endocarditis