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“UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution

BACKGROUND: The “UFO procedure” was initially developed as a surgical option to enlarge the aortic annulus in patients requiring valve replacement. This technique can be employed to treat extensive endocarditis located in the intervalvular fibrous body (IVFB). One of the indications for a "UFO...

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Autores principales: Wert, Leonhard, Pasic, Miralem, Heck, Roland, Van Praet, Karel M., Kempfert, Jörg, Jacobs, Stephan, Falk, Volkmar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214548/
https://www.ncbi.nlm.nih.gov/pubmed/37231497
http://dx.doi.org/10.1186/s13019-023-02267-5
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author Wert, Leonhard
Pasic, Miralem
Heck, Roland
Van Praet, Karel M.
Kempfert, Jörg
Jacobs, Stephan
Falk, Volkmar
author_facet Wert, Leonhard
Pasic, Miralem
Heck, Roland
Van Praet, Karel M.
Kempfert, Jörg
Jacobs, Stephan
Falk, Volkmar
author_sort Wert, Leonhard
collection PubMed
description BACKGROUND: The “UFO procedure” was initially developed as a surgical option to enlarge the aortic annulus in patients requiring valve replacement. This technique can be employed to treat extensive endocarditis located in the intervalvular fibrous body (IVFB). One of the indications for a "UFO procedure" is massive aortic and mitral valve calcification. It is a challenging surgical procedure with a high risk of intraoperative complications. CASE SUMMARY: We present a 76-year-old male patient with massive aortic and mitral valve calcification involving the left atrium, the left ventricle and the left ventricular outflow tract. Both valves exhibited severe stenosis and moderate to severe regurgitation. The left ventricle was hypertrophic and the left ventricular ejection fraction was > 55%. The patient was prediagnosed with persistent atrial fibrillation. The risk of death following heart surgery (EuroSCORE II) was calculated as 9.21%. We successfully performed a so-called “UFO procedure” including replacement of both valves without annular decalcification to avoid atrioventricular dehiscence. We enlarged the IVFB and replaced the non-coronary sinus of Valsalva with doubled bovine pericardium. The left ventricular outflow tract was decalcified. The patient was transferred to a local hospital on the 13th postoperative day. CONCLUSION: Successful surgical treatment to this extent was demonstrated for the first time. Due to the high perioperative mortality, the surgical treatment of patients with this constellation would be refused in most cases. In our patient, the preoperative imaging showed extreme calcification of both valves and the surrounding myocardium. Excellent preoperative planning and a highly experienced surgical team is necessary. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-023-02267-5.
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spelling pubmed-102145482023-05-27 “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution Wert, Leonhard Pasic, Miralem Heck, Roland Van Praet, Karel M. Kempfert, Jörg Jacobs, Stephan Falk, Volkmar J Cardiothorac Surg Case Report BACKGROUND: The “UFO procedure” was initially developed as a surgical option to enlarge the aortic annulus in patients requiring valve replacement. This technique can be employed to treat extensive endocarditis located in the intervalvular fibrous body (IVFB). One of the indications for a "UFO procedure" is massive aortic and mitral valve calcification. It is a challenging surgical procedure with a high risk of intraoperative complications. CASE SUMMARY: We present a 76-year-old male patient with massive aortic and mitral valve calcification involving the left atrium, the left ventricle and the left ventricular outflow tract. Both valves exhibited severe stenosis and moderate to severe regurgitation. The left ventricle was hypertrophic and the left ventricular ejection fraction was > 55%. The patient was prediagnosed with persistent atrial fibrillation. The risk of death following heart surgery (EuroSCORE II) was calculated as 9.21%. We successfully performed a so-called “UFO procedure” including replacement of both valves without annular decalcification to avoid atrioventricular dehiscence. We enlarged the IVFB and replaced the non-coronary sinus of Valsalva with doubled bovine pericardium. The left ventricular outflow tract was decalcified. The patient was transferred to a local hospital on the 13th postoperative day. CONCLUSION: Successful surgical treatment to this extent was demonstrated for the first time. Due to the high perioperative mortality, the surgical treatment of patients with this constellation would be refused in most cases. In our patient, the preoperative imaging showed extreme calcification of both valves and the surrounding myocardium. Excellent preoperative planning and a highly experienced surgical team is necessary. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13019-023-02267-5. BioMed Central 2023-05-25 /pmc/articles/PMC10214548/ /pubmed/37231497 http://dx.doi.org/10.1186/s13019-023-02267-5 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Wert, Leonhard
Pasic, Miralem
Heck, Roland
Van Praet, Karel M.
Kempfert, Jörg
Jacobs, Stephan
Falk, Volkmar
“UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title_full “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title_fullStr “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title_full_unstemmed “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title_short “UFO procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
title_sort “ufo procedure” for massive aortic and mitral annular calcification involving left atrial and ventricular myocardium: a potential radical solution
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10214548/
https://www.ncbi.nlm.nih.gov/pubmed/37231497
http://dx.doi.org/10.1186/s13019-023-02267-5
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