- Meeting abstract
- Open access
- Published:
Aortic root full detachment from the aortic annulus. aortitis role in the formation of a pseudoaneurysm to 3 years of an aortic valve replacement.
Journal of Cardiothoracic Surgery volume 10, Article number: A312 (2015)
Background
Ruptures of the free aortic wall or fistulas to other cardiac structures after aortic valve surgery have been described. They can be due to poor quality of the aortic wall, suture breakage, poor technique or, rarely, aortitis.
Objective
We present a rare case of complete rupture of the aortic root three years after aortic valve replacement (AVR), with formation of a large pseudoaneurysm, successfully resolved. Enterococcus faecalis RNA was found in aortic wall.
Patient and Method
A 67 year-old male is brought to the emergency room after suffering syncope. He underwent surgery for AVR 3 years earlier. The computed Tomography (CT) showed a hardly identifiable image at the site of the aortic root. There was a large shift in the origin of the coronary arteries. He underwent emergency surgery.
Results
Redo open-heart surgery was performed, using femoral cannulation, mild hypothermia at 28°C, and circulatory arrest during 4 minutes, just to open and inspect the aorta. A big cavity acting as the aortic root, with irregular contour was observed. The floor of the cavity was the aortic prosthesis, the roof the beginning of true aortic root including both coronary ostia and the walls were formed by the roof of the left atrium, the main pulmonary artery, superior vena cava, right pulmonary artery and the rests of fibrotic and adhered pericardium. Aortic prosthesis seemed normofunctional, but the walls of the ascending aorta and aortic root were inflamed. A Bentall-De bono technique was performed. An Enterococcus faecalis was identified in the aortic wall by polymerase chain reaction. He was given six weeks of antibiotic therapy.
Conclusions
Aortitis after AVR may cause complete rupture of the aortic root by its own detachment, creating a pseudoaneurysm, which might rupture. The preoperative diagnosis is not easy as well the surgical treatment.
Consent
Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.
Author information
Authors and Affiliations
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
MartinezSanz, R., Ávalos, R., de la Llana, R. et al. Aortic root full detachment from the aortic annulus. aortitis role in the formation of a pseudoaneurysm to 3 years of an aortic valve replacement.. J Cardiothorac Surg 10 (Suppl 1), A312 (2015). https://doi.org/10.1186/1749-8090-10-S1-A312
Published:
DOI: https://doi.org/10.1186/1749-8090-10-S1-A312