Publication Date
2-1-2020
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-18-6618
PMID
32148452
Publication Date(s)
February 2020
Language
English
PMCID
PMC7046353
PubMedCentral® Posted Date
2-1-2020
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Aortic diseases/pathology, echocardiography, Doppler/methods, heart failure/etiology, Marfan syndrome/complications, reoperation, treatment outcome, ventricular outflow obstruction/diagnostic imaging/etiology/physiopathology
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
A high-velocity gradient across the left ventricular outflow tract is most often caused by aortic valve stenosis. We describe the unusual case of a high-velocity gradient caused by a kinked ascending aortic graft in a 69-year-old man who had Marfan syndrome. The patient had a history of ascending aortic aneurysm and had previously undergone replacement of the aortic root and ascending aorta with use of a bioprosthetic valved graft. The kinking was caused by dilation of the native aortic arch. The patient underwent successful hemi-arch replacement and repair of the kinked graft. Late complications and reoperation after proximal aortic surgery in patients with Marfan syndrome are rare, and a high-velocity left ventricular outflow tract gradient caused by the kinking of the aorta is unusual.