Key result
Urgent pseudoaneurysm resection and tissue valved conduit insertion yields uncomplicated recovery in delayed complete dehiscence.
Why the study?
Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication typically associated with acute graft infection and symptomatic presentation.
Case Report (n=1)
Highlights a rare, delayed, and asymptomatic presentation of complete dehiscence of a mechanical aortic valve conduit and pseudoaneurysm that was successfully managed with urgent re-operation.
Answers are grounded in this paper and cite their sources.
May warrant imaging vigilance for late asymptomatic graft dehiscence post-aortic root replacement; leaves open optimal surveillance protocols.
Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication following aortic root replacement. This complication often takes place in the setting of acute graft infection and accompanies symptoms of heart failure, valve insufficiency or sepsis. We present a delayed, asymptomatic presentation of this complication in a young man with distant history of aortic root replacement and medically treated prosthetic valve endocarditis a year postoperatively. He had been non-adherent to warfarin over 10 years, but otherwise maintained a healthy life. After being lost to follow-up, he re-presented 12 years after the initial operation with new-onset seizures. Echocardiogram revealed complete dehiscence of a composite valved conduit at the proximal anastomosis site with a resultant large pseudoaneurysm. The patient underwent an urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit. He had an uncomplicated postoperative recovery and promised close follow-up on discharge.
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Oh et al. (2016) conducted a case report in Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation (n=1). Urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit was evaluated on Postoperative recovery. Urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit resulted in an uncomplicated postoperative recovery in a patient with delayed complete dehiscence.
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