Fortune or misfortune: asymptomatic, delayed presentation of complete dehiscence of mechanical aortic valve conduit and pseudoaneurysm

Kyung Taek Oh, Joseph Derose, Cynthia Taub

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Abstract

Complete dehiscence of a composite aortic valve graft with pseudoaneurysm formation is a rare complication following aortic root replacement. This complication often takes place in the setting of acute graft infection and accompanies symptoms of heart failure, valve insufficiency or sepsis. We present a delayed, asymptomatic presentation of this complication in a young man with distant history of aortic root replacement and medically treated prosthetic valve endocarditis a year postoperatively. He had been non-adherent to warfarin over 10 years, but otherwise maintained a healthy life. After being lost to follow-up, he re-presented 12 years after the initial operation with new-onset seizures. Echocardiogram revealed complete dehiscence of a composite valved conduit at the proximal anastomosis site with a resultant large pseudoaneurysm. The patient underwent an urgent re-operation with resection of the pseudoaneurysm and insertion of a tissue valved conduit. He had an uncomplicated postoperative recovery and promised close follow-up on discharge.

Original languageEnglish (US)
JournalBMJ Case Reports
Volume2016
DOIs
Publication statusPublished - Aug 16 2016

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ASJC Scopus subject areas

  • Medicine(all)

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