Aortic stenosis is the most frequent type of valvular heart disease in adult. Approximately 2-7% of the population over the age of 65 suffer from aortic valve stenosis. Due to the increasing average life expectancy in Korea, degenerative aortic stenosis is increasing and becoming a troublesome health problem in older population. Because older patients with severe degenerative aortic stenosis have many other medical conditions so they are not suitable candidate for surgery. Recently, transcatheter aortic-valve implantation (TAVI) has been suggested as a less invasive treatment for patients with high perioperative risk. We report a successful TAVI case in severe aortic stenosis patient with high perioperative risk.
Sinus of Valsalva aneurysms are rare cardiac anomalies and are usually caused by the separation of the aortic wall media from the valve ring tissue. These aneurysms frequently rupture into the low-pressure areas like the right ventricle and right atrium, rarely do they rupture into the left atrium, left ventricle, pericardial sac, or pulmonary artery. Cerebral infarction has been reported as a rare complication of unruptured sinus of Valsalva aneurysm. We experienced very rare two cases of Valsalva aneurysms of right coronary sinus dissecting into the interventricular septum in patients with cerebral infarction. In two cases these aneurysms ruptured into the left ventricle. These aneurysms were excised and the defect was closed with autopericardium. At the end of the surgical repair, coaptation was found to be insufficient and aortic valve replacement was undertaken.
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