Matsunaga Shogo, Sonoda Hiromichi, Ushijima Tomoki, Kan-O Meikun, Kimura Satoshi, Shiose Akira
Department of Cardiovascular Surgery, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan.
Gen Thorac Cardiovasc Surg Cases. 2024 Dec 31;3(1):58. doi: 10.1186/s44215-024-00182-2.
Takayasu arteritis is a large-vessel vasculitis, in addition to giant cell arteritis. Various post-operative complications associated with the cardiac macrovasculature have been reported. Detachment of the prosthetic valve, pseudoaneurysm formation, and dilatation of the aortic root are well-known post-operative complications associated with vasculitis syndromes, including Takayasu arteritis. Here, we report a rare complication involving aortic bioprosthetic valve dislodgement in the left ventricular outflow tract due to Takayasu arteritis.
A 76-year-old female underwent aortic valve replacement with a 21-mm Carpentier-Edwards Perimount valve for severe aortic regurgitation and a coronary artery bypass graft from the left internal thoracic artery to the left anterior descending artery for ischemic heart disease. Fourteen years after the initial surgery, echocardiography revealed severe aortic valve sclerosis due to structural valve deterioration of the bioprosthesis. Upon scrutiny, the bioprosthetic aortic valve was found to have dislodged into the left ventricular outflow tract. We performed re-implantation of the bioprosthetic aortic valve and replacement of the ascending aorta.
Although dislodgement of the bioprosthetic aortic valve is an extremely rare complication associated with Takayasu arteritis, the possibility that it could occur should be considered when treating the post-operative patients.
除巨细胞动脉炎外，高安动脉炎是一种大血管血管炎。已报道了各种与心脏大血管相关的术后并发症。人工瓣膜脱离、假性动脉瘤形成以及主动脉根部扩张是与包括高安动脉炎在内的血管炎综合征相关的常见术后并发症。在此，我们报告一例因高安动脉炎导致左心室流出道生物人工主动脉瓣移位的罕见并发症。
一名76岁女性因严重主动脉瓣反流接受了21毫米Carpentier-Edwards Perimount瓣膜主动脉瓣置换术，并因缺血性心脏病接受了从左胸廓内动脉到左前降支的冠状动脉搭桥术。初次手术后14年，超声心动图显示由于生物人工瓣膜结构瓣膜退变导致严重主动脉瓣硬化。仔细检查发现，生物人工主动脉瓣已移位至左心室流出道。我们进行了生物人工主动脉瓣再植入和升主动脉置换。
尽管生物人工主动脉瓣移位是与高安动脉炎相关的极其罕见的并发症，但在治疗术后患者时应考虑到其发生的可能性。
