Key result
Urgent redo AVR, pseudoaneurysm repair, and CABG successfully treats left main compression from dehiscent valve.
Why the study?
Prosthetic aortic valve dehiscence with concurrent aortic root pseudoaneurysm can cause coronary artery compression leading to coronary ischemia, complicating clinical management.
Case Report (n=1)
No
Highlights a rare complication of prosthetic valve endocarditis where an aortic root pseudoaneurysm causes external compression of the left main coronary artery, presenting as coronary ischemia.
Alerts to rare pseudoaneurysm compression in post-valve endocarditis ischemia; leaves optimal management open for prospective study.
Prosthetic aortic valve dehiscence is an uncommon complication of prosthetic valve endocarditis that may occur in patients who have undergone aortic valve replacement (AVR). The concurrent presence of aortic root pseudoaneurysm may further complicate the clinical presentation through the external compression of coronary arteries. Thus, patients may present with clinical features of coronary ischemia. Echocardiogram and coronary angiography are useful in establishing diagnosis. Treatment involves a multidisciplinary approach involving cardiologists, infectious disease specialists, and cardiothoracic surgeons. The authors of this study discuss a 51-year-old male who presented with anginal chest pain and was found to have a new left bundle branch block, elevated troponins, and left main coronary artery compression complicating aortic root aneurysm. He ended up requiring a re-do AVR, repair of the pseudoaneurysm, and coronary artery bypass graft.
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Ezeh et al. (2023) conducted a case report in Dehiscent Prosthetic Aortic Valve and Aortic Root Pseudoaneurysm (n=1). Surgical repair (re-do AVR, pseudoaneurysm repair, CABG) was evaluated. A 51-year-old male with a dehiscent prosthetic aortic valve and aortic root pseudoaneurysm causing left main coronary artery compression was successfully treated with surgical intervention.
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