Report of a case of aortitis syndrome with successful replacement of the prosthetic aortic valve and transaortic coronary endarterectomy
Komeda, M.; Miki, S.; Kusuhara, K.; Ueda, Y.; Ohkita, Y.; Tahata, T.
Nihon Kyobu Geka Gakkai 35(9): 1774-1779
1987
ISSN/ISBN: 0369-4739 PMID: 3429963 Document Number: 299658
A case of arotitis syndrome with successful emergency replacement of the prosthetic aortic valve is reported. Three years before the 2nd operation, aortic valve replacement using Omni-Science 27A was performed for aortic regurgitation caused by aortitis syndrome. Although the patient maintained a good condition after the initial operation and the anticoagulation therapy was well performed with warfarin, dysfunction of the prosthetic valve occurred with the recurrence of aortitis. During the operation, extension of the proliferated intima over the prosthetic valve, particularly the hinge portion, and formation of thrombi on the proliferated intima were observed, together with fragility of the aortic ring with the ostium of the left coronary artery (LCA) severely stenosed. Therefore, partial resection of the proliferated intima around the ostium of LCA, its blunt enlargement, and the replacement of the prosthetic aortic valve using SJM27A were performed successfully. The pathophysiology and the surgical treatment of prosthetic valvular dysfunction and the coronary ostial stenosis which can accompany aortitis syndrome are discussed.