Park, Sang Min; Jeong, Haemin; Hong, Kyung-Soon; Kim, Christopher
Medicine
2016Oct ; 95 ( 40 ) :e4860.
PMID : 27749539
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Park, Sang Min -
Jeong, Haemin -
Hong, Kyung-Soon -
Kim, Christopher -
ABSTRACT
BACKGROUND: In a patient underwent aortic valve replacement (AVR) due to bicuspid aortic valve (BAV) insufficiency without marked dilation of ascending aorta, the development of delayed-typed aneurysmal complication of ascending aorta has been often reported because the dilated aorta tends to grow insidiously with age. CASE SUMMARY: A 58-year-old man who underwent AVR with mechanical valve due to severe aortic regurgitation secondary to BAV 7 years previously presented with exertional chest discomfort for 1 year. An echocardiography showed a well-functioning mechanical aortic valve without any significant abnormal findings. Cardiac multidetector computed tomography (MDCT) revealed a huge saccular aortic root aneurysm (79.7?mm × 72.8?mm in size) compressing the proximal right coronary artery resulting in ??0% eccentric diffuse luminal narrowing. The patient subsequently underwent open-heart surgery with resection of the ascending aortic aneurysmal sac and consecutive ascending aorta and hemi-arch replacement using a graft. CONCLUSION: After successful AVR in the patient with BAV insufficiency and mildly dilated ascending aorta, a regular aortic imaging such as cardiac MDCT with aortography would be helpful to monitor the morphology and size of ascending aorta and related complications to guide future management.
aortic aneurysm, aortic valve replacement, bicuspid aortic valve, computed tomography, coronary artery
MESH
Aortic Aneurysm/*diagnostic imaging/*etiology/surgery, Aortic Valve/*abnormalities/surgery, Aortography, Coronary Angiography, Coronary Stenosis/*diagnostic imaging/etiology/surgery, Heart Valve Diseases/*complications/surgery, *Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Multidetector Computed Tomography, Postoperative Complications/*diagnostic imaging/etiology/surgery, Time Factors
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