1. Degenerated BioBentall graft with failing stentless bioprosthesis and dissection of the aortic conduit treated with a bail-out valve in valve procedure: a case report.
- Author
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Fineschi, Massimo, Contorni, Francesco, Carrera, Arcangelo, and Neri, Eugenio
- Subjects
HEART valve prosthesis implantation ,BIOPROSTHESIS ,AORTIC valve ,HEART valves ,OPERATIVE surgery ,AORTIC valve insufficiency ,COMPUTED tomography ,AORTIC dissection - Abstract
Background The Bentall procedure is commonly performed to treat combined aortic valve and ascending aorta disease requiring surgical correction. Although the technique has been shown to provide favourable long-term outcomes, both the valvular prosthesis and the aortic conduit can go through structural degeneration. Increasing use of the biological prosthesis opened to percutaneous treatment of valvular deterioration according to a valve-in-valve (ViV) technique. On the contrary, damages of the tube graft are normally referred to repeated surgical operation. Case summary In the present case, a patient with a biological Bentall graft was diagnosed with severely deteriorated stentless aortic prosthesis and dissection of the conduit arising from a tube wall tear closely located to the valvular plane. The attempted redo surgery was technically unfeasible because of severe mediastinal adhesions; therefore, a ViV procedure with a balloon expandable transcatheter heart valve was performed in order to contemporarily treat the valve prothesis dysfunction and the aortic tube dissection. No procedure-related complications occurred and subsequent aortic computed tomography angiography showed the sealing of the graft wall false lumen. Discussion Surgical reintervention remains the treatment of choice for degeneration of a previous Bentall surgery, especially when damages of the aortic conduit exist. Nevertheless, when surgery has to be discarded, ViV can be a reliable option as a bail-out strategy to deal with combined aortic valve dysfunction and tube dissection. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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