Root aneurysm following aortic valve replacement 20 years after an arterial switch operation

Abstract

Late development of annuloaortic ectasia (AAE) and progression of aortic regurgitation (AR) are widely recognized outcomes following an arterial switch operation (ASO). We treated a 29-year-old male with AAE and rapid aortic root expansion, who underwent ASO as a neonate and aortic valve replacement (AVR) as an adult. He was diagnosed as having dextro-(D-loop) transposition of the great arteries after birth and underwent ASO at the age of 13 months. At the age of 19 years, AVR was performed for progressive AR. AAE developed after AVR. In patients who have undergone neonatal ASO, AAE may occur following AVR decades later.

Valve-sparing reimplantation for neoaortic root dilatation and regurgitation with an unbalanced cusp after the arterial switch operation

“…Neoaortic root dilatation and valve regurgitation may develop after an arterial switch operation (ASO) . Aortic valve replacement has been the procedure of choice; however, valve‐sparing reimplantation has recently become more popular and demonstrates excellent long‐term outcomes .…”

“…Neoaortic root dilatation and valve regurgitation may develop after an arterial switch operation (ASO). 1 Aortic valve replacement has been the procedure of choice; however, valve-sparing reimplantation has recently become more popular and demonstrates excellent long-term outcomes. [2][3][4] We report a case of neoaortic root dilatation and valve regurgitation due to an enlarged noncoronary cusp after ASO, for which we performed a valve-sparing reimplantation using a cusp plication technique.…”

Multiple saccular aortic aneurysms following the arterial switch operation

“…Since the previous pulmonary arterial wall is exposed to higher systemic pressures after ASO, there is increased stress on the neo‐aortic wall. Therefore, histological aortic abnormalities in TGA occur not only as a result of surgical manipulations but are also an intrinsic feature of the arteries in patients with TGA …”

“…Results have constantly improved with survival up to 30 years following the ASO . Long‐term complications of the ASO include coronary artery occlusions and aortic root aneurysms . Post‐operatively, the native pulmonary valve becomes the neo‐aortic valve, and the native pulmonary root is thus subjected to systemic blood pressure.…”

Repair of a pseudoaneurysm compressing the right coronary artery in a patient with Takayasu's arteritis

“…Aortic pseudoaneurysms may occur following the replacement of the ascending aorta and arch in patients with connective tissue, congenital, or atherosclerotic disease . Patients with Takayasu's arteritis may also develop pseudoaneurysms due to calcification of aortic tissue .…”