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Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement

Due to structural abnormalities in the leaflets, patients with bicuspid aortic valve (BAV) may develop isolated aortic valve disease, such as aortic regurgitation, aortic stenosis, or a combination of both. In addition to valvular pathology, numerous studies have indicated that approximately 40% of...

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Autores principales: Niu, Hao, Liu, Lu, Gong, Xiangfeng, Wang, Haochen, Guo, Yingqiang, Zhang, Eryong, Xiao, Zhenghua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525341/
https://www.ncbi.nlm.nih.gov/pubmed/37771668
http://dx.doi.org/10.3389/fcvm.2023.1263897
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author Niu, Hao
Liu, Lu
Gong, Xiangfeng
Wang, Haochen
Guo, Yingqiang
Zhang, Eryong
Xiao, Zhenghua
author_facet Niu, Hao
Liu, Lu
Gong, Xiangfeng
Wang, Haochen
Guo, Yingqiang
Zhang, Eryong
Xiao, Zhenghua
author_sort Niu, Hao
collection PubMed
description Due to structural abnormalities in the leaflets, patients with bicuspid aortic valve (BAV) may develop isolated aortic valve disease, such as aortic regurgitation, aortic stenosis, or a combination of both. In addition to valvular pathology, numerous studies have indicated that approximately 40% of BAV patients exhibit aortic pathologies characterized by aortic dilatation. According to guidelines for valvular diseases, patients with BAV who require surgical aortic valve replacement (SAVR) and have a diameter of the aortic sinuses or ascending aorta ≥4.5 cm are recommended to undergo concomitant replacement of the aortic sinuses or ascending aorta. However, we encountered a case in 2020 involving a patient with severe aortic regurgitation due to BAV and an ascending aortic diameter of 4.2 cm. This patient underwent SAVR and ascending aortoplasty surgery at our center. Remarkably, three years postoperatively, the patient's aortic diameter rapidly expanded by nearly threefold, which also suggests the risk of encountering a giant aortic root aneurysm during reoperation. Unfortunately, a fatal rupture of a giant aortic root aneurysm was encountered during re-sternotomy. Fortunately, with adequate preoperative planning, we successfully managed to avert this perilous situation. The patient recovered without complications and was discharged on the 8th day. Individualized surgical plans were formulated based on a comprehensive evaluation of the perioperative conditions.
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spelling pubmed-105253412023-09-28 Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement Niu, Hao Liu, Lu Gong, Xiangfeng Wang, Haochen Guo, Yingqiang Zhang, Eryong Xiao, Zhenghua Front Cardiovasc Med Cardiovascular Medicine Due to structural abnormalities in the leaflets, patients with bicuspid aortic valve (BAV) may develop isolated aortic valve disease, such as aortic regurgitation, aortic stenosis, or a combination of both. In addition to valvular pathology, numerous studies have indicated that approximately 40% of BAV patients exhibit aortic pathologies characterized by aortic dilatation. According to guidelines for valvular diseases, patients with BAV who require surgical aortic valve replacement (SAVR) and have a diameter of the aortic sinuses or ascending aorta ≥4.5 cm are recommended to undergo concomitant replacement of the aortic sinuses or ascending aorta. However, we encountered a case in 2020 involving a patient with severe aortic regurgitation due to BAV and an ascending aortic diameter of 4.2 cm. This patient underwent SAVR and ascending aortoplasty surgery at our center. Remarkably, three years postoperatively, the patient's aortic diameter rapidly expanded by nearly threefold, which also suggests the risk of encountering a giant aortic root aneurysm during reoperation. Unfortunately, a fatal rupture of a giant aortic root aneurysm was encountered during re-sternotomy. Fortunately, with adequate preoperative planning, we successfully managed to avert this perilous situation. The patient recovered without complications and was discharged on the 8th day. Individualized surgical plans were formulated based on a comprehensive evaluation of the perioperative conditions. Frontiers Media S.A. 2023-09-13 /pmc/articles/PMC10525341/ /pubmed/37771668 http://dx.doi.org/10.3389/fcvm.2023.1263897 Text en © 2023 Niu, Liu, Gong, Wang, Guo, Zhang and Xiao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Niu, Hao
Liu, Lu
Gong, Xiangfeng
Wang, Haochen
Guo, Yingqiang
Zhang, Eryong
Xiao, Zhenghua
Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title_full Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title_fullStr Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title_full_unstemmed Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title_short Case report: Unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
title_sort case report: unveiling the unforeseen: a catastrophic encounter of giant aortic aneurysm rupture during re-sternotomy in a patient with bicuspid aortic valve and previous surgical aortic valve replacement
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525341/
https://www.ncbi.nlm.nih.gov/pubmed/37771668
http://dx.doi.org/10.3389/fcvm.2023.1263897
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