Reoperation for composite valve graft failure: Operative results and midterm survival

Abstract

Composite valve graft replacement can be performed with acceptable morbidity and mortality with good mid-term survival.

Massive prosthetic aortic abscess: an overarching plight 7 years post-Bentall’s procedure

“…Shah et al also illustrated in a series of 15 patients that although in-hospital mortality was only 13%, survival at 12 months remained low at 50% 7. In a recent case series, Maroto et al highlighted that excellent outcomes were achieved at 3 years follow-up (87% survival) in patients who underwent aggressive early surgical intervention with excision and composite graft replacement 5. Some studies have suggested that graft salvage may be successfully achieved with extensive mediastinal debridement, washout with antimicrobial solutions and graft coverage with a vascular tissue flap 11 12…”

“…Late postoperative infections present non-specifically depending on organism virulence and may include features of endocarditis, aneurysm, fistula formation or subacute infection with systemic features 1 3 4. In those who survive reoperation, 1-year survival ranges between 50% and 87% 2 5. Causative microorganisms are mostly S. aureus, coagulase-negative Staphylococcus, Streptococci and Enterococcus species 1 2 6.…”

Transcatheter repair of a left ventricular outflow tract pseudoaneurysm following composite aortic root replacement using an Amplatzer™ Septal Occluder

“…Endovascular technologies are increasingly available to clinicians as options for minimally invasive approaches to complex pathologies [2][3][4][5][6]. While an anastomotic pseudoaneurysm following aortic root replacement is a rare sequela, it poses a challenge given the added morbidity and potential mortality of a reoperative sternotomy [7,8]. The Amplatzer TM Septal Occluder has been previously used in a limited fashion for percutaneous closure of aortic pseudoaneurysms in 13 cases, of whom only two had prior aortic root replacements [5,6].…”

Right ventricular dysfunction 10 years following a Bentall procedure

“…It may also occur during coronary artery reimplantation in a Bentall procedure. A major indication for a reoperation following the “classic” Bentall procedure were pseudoaneurysms originating from the coronary and distal graft anastomoses . Although the modified Bentall procedure has significantly reduced the incidence of coronary artery complications, late complications may still occur.…”

“…A major indication for a reoperation following the "classic" Bentall procedure were pseudoaneurysms originating from the coronary and distal graft anastomoses. 3,4 Although the modified Bentall procedure has significantly reduced the incidence of coronary artery complications, 5 late complications may still occur. We present images of a right coronary artery (RCA) occlusion which occurred 10 years following a modified Bentall procedure which resulted in right ventricular dysfunction.…”