Giordano Vincenzo, Hermens Jeannine A J M, Wajon Elly M C J, Grandjean Jan G
Department of Cardio-Thoracic Surgery, Thoraxcentrum Twente, Medisch Spectrum Twente, Haaksbergerstraat 55, Enschede 7500 KA, The Netherlands.
Interact Cardiovasc Thorac Surg. 2011 Feb;12(2):273-5. doi: 10.1510/icvts.2010.249656. Epub 2010 Nov 2.
We report an unusual case of a 78-year-old man readmitted to our Cardiac Surgery Division due to a severe regurgitation of the stentless bioprosthesis Freedom Solo implanted, strictly following the manufacturer's recommendations, approximately six months before for aortic stenosis of native valve. Although different possible etiologies may be determined for the subacute aortic regurgitation of a bioprosthesis, a partial adhesion of a leaflet to the aortic wall represents an exceptional event. The device was explanted, a new different bioprosthesis model was implanted and the patient recovered uneventfully. But no evidence of aortic or leaflet vegetations suggesting for abscess was found, neither atheromatous or calcified plaques, nor signs of inflammation of the aortic wall were detected. In the end, it is believed that the cause of the cuspal adhesion to the aortic sinus was primary tissue failure.
我们报告了一例不同寻常的病例，一名78岁男性因植入的无支架生物瓣膜Freedom Solo出现严重反流而再次入住我们的心外科，该瓣膜是大约六个月前严格按照制造商的建议，为其自身瓣膜主动脉狭窄而植入的。尽管生物瓣膜亚急性主动脉反流可能有不同的病因，但瓣叶与主动脉壁的部分粘连是一种罕见情况。该装置被取出，植入了一种新的不同生物瓣膜模型，患者顺利康复。但未发现提示脓肿的主动脉或瓣叶赘生物迹象，也未检测到动脉粥样硬化或钙化斑块，以及主动脉壁的炎症迹象。最后，认为瓣叶与主动脉窦粘连的原因是原发性组织衰竭。
