Abstract
We report the case of a patient who was found to have an aorto-right ventricular fistula 17 years after receiving a Björk-Shiley prosthetic aortic valve. A pseudoaneurysm had formed at the aortotomy suture line, and it had extended into the interventricular septum and had eventually opened into the right ventricle. Using transesophageal echocardiography, we identified the defect in the ascending aorta, and a left-to-right shunt. Aortography was used to confirm these findings. The pseudoaneurysm was successfully resected and the ascending aorta was replaced with a Dacron graft. To the best of our knowledge, no similar late complication of aortic valve replacement has been reported in the medical literature.
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- Albat B., Leclercq P. F., MessnerPellenc P., Missov E., Thevenet A. False aneurysm of the ascending aorta following aortic valve replacement. J Heart Valve Dis. 1994 Mar;3(2):216–219. [PubMed] [Google Scholar]
- Barnhorst D. A., Oxman H. A., Connolly D. C., Pluth J. R., Danielson G. K., Wallace R. B., McGoon D. C. Long-term follow-up of isolated replacement of the aortic or mitral valve with the Starr-Edwards prosthesis. Am J Cardiol. 1975 Feb;35(2):228–233. doi: 10.1016/0002-9149(75)90006-5. [DOI] [PubMed] [Google Scholar]
- Björk V. O., Edhag O. Aortic sinus aneurysm. Report of an unusual case. Scand J Thorac Cardiovasc Surg. 1972;6(2):136–139. doi: 10.3109/14017437209134791. [DOI] [PubMed] [Google Scholar]
- Björk V. O., Henze A., Jereb M. Aortographic follow-up in patients with the Björk-Shiley aortic disc valve prosthesis. Scand J Thorac Cardiovasc Surg. 1973;7(1):1–6. doi: 10.3109/14017437309139158. [DOI] [PubMed] [Google Scholar]
- Dzavik V., Cohen G., Chan K. L. Role of transesophageal echocardiography in the diagnosis and management of prosthetic valve thrombosis. J Am Coll Cardiol. 1991 Dec;18(7):1829–1833. doi: 10.1016/0735-1097(91)90527-g. [DOI] [PubMed] [Google Scholar]
- Roberts W. C. Complications of cardiac valve replacement: characteristic abnormalities of prostheses pertaining to any or specific site. Am Heart J. 1982 Jan;103(1):113–122. doi: 10.1016/0002-8703(82)90537-3. [DOI] [PubMed] [Google Scholar]
- Roberts W. C., Hammer W. J. Cardiac pathology after valve replacement with a tilting disc prosthesis (Björk-Shiley type). A study of 46 necropsy patients and 49 Björk-Shiley prostheses. Am J Cardiol. 1976 Jun;37(7):1024–1033. doi: 10.1016/0002-9149(76)90419-7. [DOI] [PubMed] [Google Scholar]
- Sullivan K. L., Steiner R. M., Smullens S. N., Griska L., Meister S. G. Pseudoaneurysm of the ascending aorta following cardiac surgery. Chest. 1988 Jan;93(1):138–143. doi: 10.1378/chest.93.1.138. [DOI] [PubMed] [Google Scholar]