Publication Date
4-1-2020
Journal
The Texas Heart Institute Journal
DOI
10.14503/THIJ-17-6506
PMID
32603453
Publication Date(s)
April 2020
Language
English
PMCID
PMC7328075
PubMedCentral® Posted Date
6-17-2020
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
yes
Keywords
Aortic valve, surgery; endocarditis, bacterial/surgery; prosthesis-related infections/surgery; ventricular outflow obstruction/surgery; reconstructive surgical procedures/methods
Copyright
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Abstract
Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aortic annulus destruction and aortoventricular discontinuity. This modified technique enables safer, more secure anchoring of a replacement valve, reduces the risks and concerns associated with bypass grafts, and successfully treats aortoventricular discontinuity.