Division of Cardiac Surgery, University of Palermo, 90127 Palermo, Italy.
Division of Radiology, University of Palermo, 90127 Palermo, Italy.
Tex Heart Inst J. 2020 Apr 1;47(2):117-120. doi: 10.14503/THIJ-17-6506.
Endocarditis is a devastating complication of prosthetic aortic valve replacement. The infective process can destroy aortic annulus tissue, making conventional surgical valve replacement difficult or impossible and causing aortoventricular discontinuity. Several treatment techniques have been proposed. One of these, the Danielson technique, involves translocating the aortic valve to the native ascending aorta, débriding the abscess cavity, closing the coronary ostia, and bypassing the coronary arteries with a Y anastomosis between 2 vein grafts. We describe our use of a modified Danielson technique in a 68-year-old man with advanced prosthetic valve endocarditis that was associated with aortic annulus destruction and aortoventricular discontinuity. This modified technique enables safer, more secure anchoring of a replacement valve, reduces the risks and concerns associated with bypass grafts, and successfully treats aortoventricular discontinuity.
人工主动脉瓣置换术后的心内膜炎是一种破坏性的并发症。感染过程会破坏主动脉瓣环组织，使得传统的外科瓣膜置换术变得困难或不可能，并导致主动脉-心室连续性中断。已经提出了几种治疗技术。其中之一是 Danielson 技术，它涉及将主动脉瓣移至原生升主动脉，清创脓肿腔，关闭冠状动脉口，并通过在 2 个静脉移植物之间进行 Y 吻合来绕过冠状动脉。我们描述了我们在一名 68 岁男性中使用改良的 Danielson 技术的情况，该男性患有晚期人工瓣膜心内膜炎，伴有主动脉瓣环破坏和主动脉-心室连续性中断。这种改良技术可以更安全、更可靠地固定替换瓣膜，降低旁路移植术相关的风险和顾虑，并成功治疗主动脉-心室连续性中断。
