Publication Date

2-1-2014

Journal

The Texas Heart Journal

DOI

10.14503/THIJ-12-3049

PMID

24512405

Publication Date(s)

February 2014

Language

English

PMCID

PMC3967484

PubMedCentral® Posted Date

2-4-2014

PubMedCentral® Full Text Version

Post-Print

Published Open-Access

yes

Keywords

Aortic Valve, Aortic Valve Insufficiency, Bicuspid Aortic Valve Disease, Cardiac Surgical Procedures, Echocardiography, Doppler, Color, Echocardiography, Transesophageal, Endocarditis, Bacterial, Heart Valve Diseases, Humans, Male, Middle Aged, Severity of Illness Index, Streptococcal Infections, Time Factors, Treatment Outcome, Viridans Streptococci

Abstract

Aortic valve repair can be a good option in younger patients who have severe aortic regurgitation. A systematic, disease-directed approach can simplify repair. This case report describes how a simplified approach can be successfully applied to complex pathologic conditions of the aortic valve.

A 49-year-old man with a bicuspid aortic valve and a history of endocarditis presented with severe aortic regurgitation and evidence of recurrent infection. Intraoperatively, we found congenital and degenerative aortic anatomy with endocarditis and perforation. We performed aortic valve repair to enable leaflet coaptation and to adjust the coaptation height. After 24 months, the patient remained well, with an intact repair and trivial aortic regurgitation. We describe our systematic repair approach and rationales for targeting repairs to identified lesions. To our knowledge, this is the first description of complex aortic valve repairs in a patient who had simultaneous congenital, degenerative, and infectious conditions.

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