LEFT VENTRICULAR OUTFLOW TRACT

RECONSTRUCTION FOR ANNULAR EROSION

LEFT VENTRICULAR OUTFLOW TRACT

RECONSTRUCTION FOR ANNULAR EROSION

Sotiris Stamou, MD, Michael Murphy, MD and Nicholas T. Kouchoukos, MD

Division of Thoracic and Cardiovascular Surgery

Missouri Baptist Medical Center

Sotiris Stamou, MD, Michael Murphy, MD and Nicholas T. Kouchoukos, MD

Division of Thoracic and Cardiovascular Surgery

Missouri Baptist Medical Center

Indications Indications

•When destruction or distortion of the annulus precludes safe placement of prosthetic valve

•When insertion of a prosthesis would result in LVOT or coronary obstruction

•When destruction or distortion of the annulus precludes safe placement of prosthetic valve

•When insertion of a prosthesis would result in LVOT or coronary obstruction

MethodsMethods

• N=10

• 6 males

• Median age: 49

• Range: 26 to 61 years

• Indications:Endocarditis (3) calcification of aortic root (1) pseudoaneurysm (2) obstruction of aortic valve prosthesis (1) degeneration of allograft (3)

• N=10

• 6 males

• Median age: 49

• Range: 26 to 61 years

• Indications:Endocarditis (3) calcification of aortic root (1) pseudoaneurysm (2) obstruction of aortic valve prosthesis (1) degeneration of allograft (3)

MethodsMethods

•Previous operation:

•Aortic root allograft (5)

•Composite Graft aortic root replacement (3)

•Aortic valve replacement (n=1)

•Previous operation:

•Aortic root allograft (5)

•Composite Graft aortic root replacement (3)

•Aortic valve replacement (n=1)

ResultsResults

•All patients survived the operation

• Two late deaths from renal failure and cardiac failure

• 8 Patients alive 1 to 84 months postoperatively

•All patients survived the operation

• Two late deaths from renal failure and cardiac failure

• 8 Patients alive 1 to 84 months postoperatively

ConclusionConclusion

• LVOT reconstruction and translocation of the aortic valve for annular erosion is a useful technique that eliminates bleeding from the annular suture line, LVOT obstruction and can be safely performed with satisfactory outcomes

• LVOT reconstruction and translocation of the aortic valve for annular erosion is a useful technique that eliminates bleeding from the annular suture line, LVOT obstruction and can be safely performed with satisfactory outcomes