ABSTRACT
In selected cases of aortic regurgitation, aortic valve (AV) repair and AV sparing root reconstruction viable alternatives to aortic valve replacement. Repair and preservation of the native valve avoids the use of long-term anticoagulation, lowers the incidence of subsequent thromboembolic events and reduces the risk of endocarditis. Additionally repair has a low operative mortality with reasonable mid-term durability. The success and longer term durability of AVPP has improved with surgical experience. An understanding of the mechanism of the AR is integral to determining feasibility and success of an AVPP. Assessment of AV morphology, anatomy of the functional aortic annulus (FAA) and the aortic root with transesophageal echocardiography (TEE) improves the understanding of the mechanisms of AR. Pre- and intra-operative TEE plays a pivotal role in guiding case selection, surgical planning, and in evaluating procedural success. Post-operative transthoracic echocardiography is useful to determine long-term success and monitor for recurrence of AR.
Subject(s)
Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/surgery , Aortic Valve/surgery , Echocardiography, Transesophageal/methods , Heart Valve Prosthesis , Surgery, Computer-Assisted/methods , Aortic Valve/diagnostic imaging , HumansABSTRACT
Sinus of Valsalva aneurysms (SOVA) are rare cardiac abnormalities that are most commonly congenital in origin and frequently associated with aortic valve pathology. Unruptured SOVA are more frequently identified currently, owing to the increased use and accuracy of diagnostic investigations. Early surgical intervention is recommended to prevent complications. We describe a case of a young patient with an enlarging right SOVA and a regurgitant bicuspid aortic valve who subsequently underwent simultaneous patch repair of the SOVA and primary aortic valve repair.
